Spa Treatment Acknowledgment
business name — client guest name, on date. Treatment: treatment. Therapist: therapist name.
- What the treatment is. treatment description. I have been told what it involves, how long it takes, what it will feel like, and what to expect afterwards.
- Not medical treatment. This is a beauty or relaxation service. It is not medical care, the therapist is not a clinician, and nothing here diagnoses or treats a condition. If I have a condition, I will see a doctor about it.
- My health. I have told the salon truthfully about anything on this list that applies to me: health disclosures — including skin conditions, recent waxing, peels or laser work, retinoids and acne medication, sunburn, allergies, diabetes, circulation or nerve conditions, recent surgery, blood thinners, and whether I am pregnant or breastfeeding. I understand some treatments cannot be done safely with some of these, and that the salon may decline.
- Waxing and hair removal, where that is the treatment. I understand that skin may lift if I have used retinoids, acne medication or had a peel recently, and that redness, bumps, ingrown hairs and temporary sensitivity are normal. I have disclosed everything I use on the area: skincare products.
- Draping and comfort. I will be draped, only the area being worked on is uncovered, and I can ask the therapist to stop, change pressure or leave the room at any moment, for any reason, with no explanation needed.
- Aftercare. I have been given aftercare instructions, including what to keep off the area and for how long, and I understand that heat, sun, swimming and friction in the first aftercare hours hours are the common causes of a poor result.
- Release. To the extent the law where business name operates allows, I release business name and its staff from claims arising from the ordinary and disclosed risks of this treatment and from a reaction caused by something I did not disclose, other than claims arising from their negligence.
By signing I confirm that I have read this, had every question answered, and meant to sign it.








