Spray Tan Consultation & Consent Form

Spray Tan Consultation & Consent

Name

First Name

Last Name

Phone

(###)

###

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Are you 18 & over?

How did you hear about us?

Referral Name

Have you received a spray tan before?

Do you have any allergies?

If yes, Please list:

Do you have any skin conditions?

If Yes, please list:

Do you have any respiratory illnesses?

Are you currently breastfeeding or pregnant?

If yes, do you have permission to tan from your doctor?

Is this spray tan for a special occasion?

Your Skin Type is:

How dark would you like to be?

Type of Tan I want:

Express (shower in 2-4 hours)

Regular (shower after 8-12 hours of development)

Please Read, Understand, And Sign the Following:

Spray tanning is accomplished by application of a solution containing the active ingredient Dihydroxyacetone (DHA). Our solution is 100% organic, non-toxic, paraben free, gluten free, sulfate free, nut-allergen free, propylene glycol free, phthalates free, and synthetic fragrance free. Our solution does not provide any UV protection. Use SPF sun protection as usual. If you have sensitive skin or allergies to sunless tanning products containing DHA, or if you are unsure whether you may be allergic to DHA, we strongly suggest consulting your physician prior to tanning. We have copies of our solution ingredients for your physician upon request. If you have had adverse effects utilizing self-tanning products or moisturizers in the past, you may experience similar effects with sunless spray tan systems. Be advised that a small percentage of people have skin that does not react favorably to spray tanning. For this reason, we highly advise doing a trial spray tan when your appearance is critical; e.g., wedding, special occasion, photographic session, modeling assignment, etc. If you are pregnant or nursing, we recommend each customer consult with their personal physician before receiving a DHA sunless spray tan application. You should prepare your skin for your session prior to your arrival. Skin should be free of deodorant, sweat, fragrances, lotions, and it should be clean, dry, exfoliated (removal of dead, dry skin cells) and shaved. Remove all make-up and do not wear jewelry of any kind. If you attend your appointment without proper preparation, Bare Bronze Beauty cannot guarantee lasting or satisfactory results. During your spray tan you may wear a dark colored bathing suit, underwear, thong, strapless bra, or whatever you feel comfortable in. You may go topless if you choose. Bottoms are required. Bare Bronze Beauty can provide disposable undergarments. Men must wear shorts, boxers, underwear, or bathing suit. Cosmetic bronzers in the solution will wash out of most fabrics. Silk, Lycra, spandex, nylon, wool or leather has the possibility to stain. For optimum results, wait 8 hours before bathing/showering. Avoid any activities that will cause perspiration, moisturizing your skin, or applying makeup until after your first shower. You may see the immediate bronzing color wash-off of your skin during your first shower, this is just the color guide and does not affect the spray tan. I verify with my signature that I am at least 18 years of age and, if under 18 years of age I have been given permission to tan from my parent or legal guardian.

Please Checkmark:

To my knowledge, I have no medical condition or allergy which would preclude me from having this procedure done. I attest that I have provided accurate age and identity verification. I acknowledge that the results of sunless tanning do vary, and that no guarantees of specific results are offered or implied. Bare Bronze Beauty will not refund or credit any amount of money because of a client’s unhappiness with their final results. I agree to hold Bare Bronze Beauty and all authorized representatives harmless from any liability involved in the spray tanning process. I take sole responsibility of any reaction I may have, staining of clothing and/or personal belongings. Bare Bronze Beauty and their staff have explained this procedure to me and all of my questions, if any, were answered. I have reviewed and completely understand all of the information at www.barebronzebeauty.com, including this form.

Name

First Name

Last Name

Date

YYYY