General Information and Consent Form

Client Information:

Full Name

Date of Birth

Address

City

State

Zip Code

Phone Number

Email Address

Medical History:

Have you ever experienced any allergic reactions to beauty products or treatments in the past? (If yes, please specify)

Do you have any medical conditions that may affect your spa treatment? (If yes, please specify)

Are you currently taking any medication? (If yes, please specify)

Consent:

By signing this form, I confirm that I have provided accurate information regarding my medical history and allergies. I understand that it is my responsibility to inform the Luxo Nail Spa staff of any changes in my health status or medication. I agree to participate in the treatments offered by Luxo Nail Spa and release Luxo Nail Spa and its staff from any liability in the event of injuries or adverse reactions, unless resulting from negligence on the part of Luxo Nail Spa staff.

By checking this box, I confirm that I have read and accepted the terms and conditions of Luxo Nail Spa.

Date