Client Waiver & Consent Form – Skin & Treatment Disclosure

Skin & Treatment Disclosure - Form

Skin & Treatment Disclosure

Please complete this form prior to your beauty service.

First Name

Last Name

Treatment

Date

Botox Disclosure & Consent

I confirm that I have received Botox (Botulinum Toxin) treatment in the past and acknowledge the following:

Disclosure ObligationI have voluntarily disclosed that I have received Botox injections. I understand that Botox-treated skin may be more sensitive or reactive to certain beauty treatments such as threading, waxing, tinting, or lash services.Information ProvidedI have been informed by Brow Bar staff that clients with Botox may experience increased sensitivity or unpredictable reactions to beauty services, including:Redness, bruising, or swellingIrritation or sensitivity of the skinDelayed healing or unexpected aesthetic outcomes

Voluntary Consent: I acknowledge that despite the above risks, I wish to proceed with the requested beauty treatment(s) today.

Waiver of Claims: I fully accept responsibility for any adverse effects that may arise due to my Botox history. I agree that Brow Bar, its staff, and service providers will not be held liable for any minor reactions or complications unless caused by proven gross negligence or misconduct.

I confirm I have read and understood this waiver and wish to proceed with today’s service.

Client Signature (Type Full Name)

Therapist Name

Therapist Signature