Facials Form

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Please note, you must fill out this form before our appointment.

First Name

Last Name

Phone

Address

Choose your treatment

Your skin may experience temporary irritation, tightness, or redness. These are all normal reactions that typically resolve within 72 hours depending on skin sensitivity. You may experience tingling and stinging in the treatment area. These sensations generally subside within a few hours. Client experiences may vary. Some clients may experience a delayed onset of these symptoms. You will likely see results after 5 days after treatment and your skin may feel smooth and hydrated for one to four weeks with appropriate home care to maintain treatment results. The skin is more susceptible to sunburn/sun damage. Avoid excessive sun exposure and use a minimum of SPF 40 sunscreen. I will avoid the use of aggressive exfoliation, waxing, and products containing glycolic acids or retinol that are not part of the recommended take-home regimen in the treated areas for a minimum 2 weeks pre-and post-treatment.

I am aware that results vary between clients and results are dependent on many individual factors. I am aware that there is no guarantee that I will achieve the desired results and that repeat treatments are required to maintain results.

RIGHT TO DISCONTINUE TREATMENT I understand that I have the right to discontinue treatment at any time & I understand payment will still have to be made in full.

I have been advised of the relevant information associated with this treatment and I confirm that I fully understand this advice.

PHOTOGRAPHS AND VIDEOS: I agree to and authorise the taking of photographs and videos. I understand that these photographs and videos may be used on social media platforms.

All deposits and booking fees are non-refundable unless agreed to with the practitioner.

I certify that I have read the above consent and that I fully understand it. I have been given ample opportunity for discussion and all my questions have been answered to my satisfaction. No new information has become available that affects my decision to have the treatment or my decision to consent. I hereby consent to this procedure, carried out by a practitioner at House Of Luxe.

Do you understand the information you have been provided? * Required

Yes

Do you have any medical conditions? * Required

Yes

Are you pregnant or breastfeeding? * Required

Yes

Do you have a neuromuscular disease (e.g. MS, ALS, motor neuropathy myasthenia gravis, or Lambert-Eaton syndrome)? * Required

Yes

Do you have an autoimmune disease? * Required

Yes

Are you taking antibiotics or other prescription medications? * Required

Yes

Do you have any skin conditions? * Required

Yes

Do you have any known allergies or have ever had anaphylaxis? * Required

Yes

Do you have any active infection at the intended site of procedure? * Required

Yes

Is there any other Medical and/or Social History that we should know? If so, please provide full detail below. * Required

Yes

If yes, please add Medical/Social History that we should know.

Have you had this or a similar treatment before? If so, did you experience any problems? Please provide full details below. * Required

Yes

If you experienced any problems, please add them here.

Do you have any concerns? If so, please provide full details below. * Required

Yes

If you have any concerns, please provide details here.

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About us

Hey! I’m Katie , the owner of House of Luxe, my gorgeous little home salon where all the magic happens.

I’m a bridal and events hairstylist with a true love for making beautiful women feel even more beautiful. Being able to call this my job is something I feel incredibly grateful for.

With a calm, gentle, and kind nature, I’m there to make sure your day runs as smoothly as possible, whether it’s your wedding morning or a special occasion. From helping you get ready to offering those little words of reassurance, I’ll be by your side to assist, support, and make sure everything feels just right.

Bridal hair and styling is a particular passion of mine, and I bring this to life through The Updo Edit, a dedicated part of House of Luxe where I create timeless, elegant looks for weddings and special events. From the moment you sit in my chair until the second you leave (or walk down the aisle!), I’ll ensure every detail of your hair is perfect, leaving you feeling radiant, confident, and completely yourself.

FACIALS FORM

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