Back Home

Scheduling & Gifts






Powered by Vagaro Salon SoftwareSpa Software & Fitness Software
All Gift Certificates are redeemable with Tara Smith, Licensed Esthetician and Manicurist

For MASSAGE Gift Certificates, call Maximum Effects Directly


Facial Consent Form


Please click on link and read. Then choose Advances Therapies Option below for consent.

Consent Form for Advanced Therapies




Health history for Facial services
Name
Phone
Address
Email address
Birth Date
Skin Type
Are you currently under a physician's care?
List any surgeries you had within the last 9 months
Medications, Vitamins, and or special concerns pertaining to your skin?
What skin care products are you currently using?
Do you experience breakthrough oily shine during the day?
Do you experience skin breakouts?
Have you or do you?
Do you have any metal implants in your body?
How much water do you consume daily? (ex. ounces)
Do you ever experience these conditions?
Do you use sunscreen, sun block, SPF?
Do you burn easily in moderate sunlight?
Do you blush easily when nervous?
Do you have a tendency to redness?
Have you suffered sinus problems?
DO YOU HAVE ROSACEA?
Are you Claustrophobic?
What massage pressure do you prefer?
Have you had recent dental X-Rays?
I give consent for facial services.
I give consent for Advanced Therapies and Enzyme Facials