Bonbae Glow Client Intake + Consent Form

Your Name

DOB

Gender

Phone Number

Email Address

Emergency Contact Name & Relationship

Emergency Contact Phone Number

Personal Medical History (Please Select ALL that Apply)

Are you currently being treated for any of the conditions above? If Yes, please indicate. Otherwise type “no”

Do you have other any known allergies that were not mentioned? If yes, please indicate. If no, please type “no”.

Are you currently taking any medications or using any products that may affect your tan? If yes please describe. If no, please type “no”.

Have you previously ever received a spray tan?

Yes, by an artist

Yes, by Sun Tan City

Yes, Other

Have you ever experienced any adverse reactions from using self tanning products or receiving a spray tan? If yes, please describe what product and what happened. If no, please type “no”.

You understand, accept and agree that exfoliating 24 hours prior to your appointment is highly recommended

You understand, accept and agree that shaving 12-24 hours prior to your spray tan is highly recommended, as this helps to ensure your pores are closed for your appointment

You understand, accept and agree that using any moisturizer, oils, or lotions on the skin prior to you appointment plays a negative factor in your overall spray tan application

You understand that wearing any makeup, perfume or deodorant will need to be completely removed prior to appointment

Do you wear contact lenses?

Are you currently nursing or pregnant?

What is your skin type?

Skin Burns, Rarely Tans

Skin Burns, then Tans to Light or Medium

Skin Rarely Burns, Tans Easily to Medium or Dark

What is your skin undertone in natural light?

Cool (blue-purple like veins)

Warm (green veins

Neutral (mix of both or hard to see veins)

I completed the above form to the best of my knowledge. I have had the opportunity to ask any questions and have received satisfactory answers. I will inform the technician of any changes to the above information. I am over the age of 18 and consent to the procedure. If 1 am under the age of 18, my parent/guardian must sign below. I will not hold the technician, salon, or employees liable for any injury or damage that may occur as a result of the spray tan procedure for any issues not disclosed at the time of my service.

Yes

By Signing, you acknowledge that you completed the above form to the best of of your knowledge. You have had the opportunity to ask any questions and have received satisfactory answers. You will inform the technician of any changes to the above information.
You are over the age of 18 and consent to the procedure. If you are under the age of 18, your parent/guardian must sign below. You will not hold the technician, salon, or employees liable for any injury or damage that may occur as a result of the spray tan procedure for any issues not disclosed at the time of my service.

Signature