Consultation Forms

Click on your appointment form below!

If you book an appointment with us please fill out an intake form BEFORE your appointment we cannot take any new clients without this form (fill out ALL forms needed for multiple appointments) . We have gone digital due to COVID-19 for your safety and ours. Thank you for your understanding!

Facial Consultation form

Lash Lift Consultation Form

First name

Last name

Phone number and best day and time to reach

Birthday

Do you have any allergies to latex or lash glue that you know of?if not, do you have any other allergies we should be aware of ?

I agree to have no contacts during my procedure for my safety

Emergency contact name and phone number:

How did you hear about us? so we can thank them!

Have you ever had a lash lift before?

Are you pregnant or breastfeeding?

Any health conditions we need to be aware of?

Do you have any eye prescription medication?

I give permission to Energe Spa to use my Image or short video for liability records to record the progress of my skin. If my photo has been selected for marketing purposes, i give permission to publish my images with concealed facial recognition by covering of the eyes, as well as none of my personal information. (type AGREE OR DISAGREE)

All of the above information is true and accurate to the best of my knowledge. I take full responsibility for alerting my esthetician any physical or mental condition which would affect my service or results. I understand my treatment is therapeutic in nature and i will alert my therapist if any discomfort. (Type AGREE/DISAGREE)

(WAIVER) I agree i will assume the risk and full responsibility for any and all injuries, losses, or damages, which might occur to me while i am undergoing this procedure or side effects i may experience after the procedure. I understand that all skin is different and reacts different. I agree to waive and release any and all present and future claims, suits and related causes of action against the esthetician , energe spa, its service providers, owners, officers, employees, or agents for negligence, injury, loss, death, costs or toher injuries or damages to me as a result of this procedure. I agree this waiver and release shall bind the members of my family and any spouse or domestic partner, if i am alive, as well as my state, family, heirs, administrators, personal representatives or assigns if I am deceased, and shall be deemed as a "release, waiver, discharge and covenant" not to sue Energe Spa or any of its service providers or owners. Maximum liability the energe spas maximum aggregate liability to patient related to or inconnection with the procedure described in the authorization and consent. (type AGREE/DISAGREE WITH YOUR INITIALS)

Thank you! and we cant wait to see you in your appointment! our trained professionals love what they do and will make your lashes look fab! (follow us on instagram and facebook to see our work!) If you have any question or anything you would like us to know feel free to type below! (if none just type N/A)

Massage Consultation Form

Waxing Consultation Form

First name

Last name

Phone number and best day and time to reach

Birthday

Do you have any allergies to latex ? If not, do you have any other allergies we should be aware of ?

Emergency contact name and phone number:

Have you ever had a wax service done before? When?

Any health conditions we need to be aware of?

When was the last time you exfoliated the area you would like to get waxed?

Have you taken any skin thinning products or medicines?

Have you used a tanning bed? When?

How did you hear about us?

Do you currently have any open sores, wounds, or irritated skin on or areound the area to be waxed?

yes no

Thank you! and we cant wait to see you in your appointment! our trained professionals will do their best to keep you comfortable and relaxed during your service. (follow us on instagram and facebook to see our work!) If you have any question or anything you would like us to know feel free to type below! (if none just type N/A)

Consultation Forms

Click on your appointment form below!

Facial Consultation form

Lash Lift Consultation Form

Massage Consultation Form

Waxing Consultation Form

Stay in touch!

Let’s Chat!

Click on your appointment form below!

Facial Consultation form

Lash Lift Consultation Form

Massage Consultation Form

Waxing Consultation Form

Stay in touch!

Let’s Chat!

Stay social!