Facial Consent Form (Canada)

Form Template

The Facial Consent Form (Canada) is a template that can be used by estheticians to get general medical history information from clients prior to treatment, as well as have them sign a consent form for the procedure.

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Questions on the form include listing medications, specific skin care or allergy issues, previous skin treatments, whether the client easily gets sun burn, breakouts, oily skin problems etc.

The consent form section informs the client that they should inform the esthetician if they experience any pain or discomfort during the procedure, and that no diagnosis can be made by the esthetician. It also states that the esthetician has the rights to refuse treatment to any client if they believe there are contraindications for facial treatments. There is also a section to gather to signature of the client. The form can be fully customized to meet the needs of the specific business.

  • Signature Capture
  • Conditional Fields
  • Submission Editing
  • Reference Data
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