Skin Care Intake Form

Skin Care Intake Form

Clients need to fill this form out prior to their skin care appointment
  • If none apply please select "none of these"
  • If I experience any pain or discomfort during this session, I will immediately inform the Esthetician so that the session may be adjusted to my level of comfort. I further understand that esthetics should not be considered as a substitute for medical examination, diagnosis, or treatment, and that i should see a physician, or other qualified medical specialist for any mental or physical ailment that i am aware of. I understand that licensed Esthetician's are not qualified to diagnose, prescribe, or treat any physical or mental illness and nothing that is said in the course of the session given should be construed as such. Because esthetics should not be performed under certain medical conditions, i affirm that I have stated all my known medical conditions, and answered all questions honestly. I agree to keep Bethesda Salt Cave and the Esthetician updated as to any changed in my medial profile and understand that there shall be no liability on Bethesda Salt Cave and the esthetician's part should i fail to do so.