Before your first appointment

Consent & waiver form

One universal form covers every treatment we offer. It takes about five minutes, is signed right here on this page, and saves paperwork on the day of your visit. Your answers are kept private and used only to treat you safely — see our privacy policy.

Your details

Fields marked * are required.

Full legal name *

Date of birth *

Email *

Mobile phone *

Home address *

Emergency contact name

Emergency contact phone

Your appointment

Treatment *

Appointment date (if already booked)

Health history

Tick anything that applies — most conditions don't rule out treatment, they just change how we work. When in doubt, tick it and we'll talk it through.

Allergies

Current medications

Anything else we should know about your skin or health?

Consent terms

Please read before signing — this is the agreement you are signing.

1. Services

This agreement covers professional esthetic services provided by The Selfcare Studio ("the Studio") at the Studio's premises in Austin, Texas, or at a location I choose for mobile (traveling) services, including facial treatments, chemical peels, dermaplaning, microneedling, high-frequency scalp treatments, and back, hand, and foot treatments (together, "the Services").

2. Nature of treatment & risks

Esthetic treatments carry inherent risks even when performed correctly, including but not limited to: temporary redness, swelling, tenderness, dryness or flaking; bruising; breakouts or purging; allergic or sensitivity reactions; hyper- or hypo-pigmentation; infection; and scarring. I understand that individual results vary and cannot be guaranteed.

3. Health disclosure

The Studio's ability to treat me safely depends on the accuracy of the health information I provide. I agree that the information in this form is complete and accurate to the best of my knowledge, and that I will disclose any changes — including new medications, pregnancy, or skin conditions — before each appointment. The Studio may decline or modify treatment based on this information; this is a safety decision made in my interest.

4. Electrical modalities

High-frequency treatment applies a low-level electrical current to the skin or scalp. I confirm I will disclose any pacemaker or other electronic implant, epilepsy or seizure disorder, metal implants in the treatment area, or pregnancy, and I understand the Studio will decline this treatment where any of these apply.

5. Patch testing

A patch test for peel solutions and active-ingredient products is available on request at least 48 hours before treatment. If I decline a patch test, I accept the increased risk of an unforeseen reaction.

6. Aftercare

I will receive written aftercare instructions for my treatment and agree to follow them. I understand that healing and results depend significantly on aftercare, sun protection, and my skin's individual response.

7. Photographs

Before-and-after photographs may be taken for my client record. Separately, I may opt in below to allow anonymized use of such photographs for the Studio's portfolio and social media; declining has no effect on my treatment.

8. Cancellation

Appointments cancelled or rescheduled with less than 24 hours' notice may incur a fee of up to 50% of the booked service. Booking deposits are non-refundable within the same window.

9. Assumption of risk & release

In consideration of receiving the Services, I knowingly and voluntarily assume all risks described above, and release and hold harmless The Selfcare Studio, its owner, employees, and contractors from any claims, damages, or causes of action arising from the Services, except those caused by gross negligence or willful misconduct. This release binds me, my heirs, and legal representatives.

10. Data & privacy

My information, including the health details above and my signature, will be stored securely and used only for treatment, safety, and record-keeping purposes as described in the privacy policy. It is never sold or shared for marketing.

I have read the consent terms above and understand the nature, benefits, and possible risks of the treatment(s) I am booking. I confirm the health information I provided is complete and truthful, and I will inform The Selfcare Studio of any changes before my appointment. I understand a patch test is available on request for peel solutions and active-ingredient treatments at least 48 hours before treatment, and that declining one is my choice. I agree to follow the written aftercare instructions provided, and understand results depend partly on aftercare compliance. I understand results vary from person to person and no specific outcome has been guaranteed. I understand appointments cancelled or rescheduled less than 24 hours in advance may incur a fee, and that any booking deposit is non-refundable within that window. I knowingly and voluntarily assume the risks of treatment and release The Selfcare Studio, its owner, and staff from liability for claims arising from the services performed, except in cases of gross negligence or willful misconduct. I confirm I am at least 18 years old and legally able to sign this agreement for myself. Optional: I consent to anonymized before/after photos being used in The Selfcare Studio's portfolio and social media.

Signature

Type your full legal name as your signature *

Draw your signature *

Sign here with mouse or finger

By submitting, you sign this agreement electronically and agree that your electronic signature has the same effect as a handwritten one.

Prefer paper? No problem — mention it when you book and a printed copy will be ready to sign at the studio before your treatment begins.