CONSENT FORMS

The State of Massachusetts requires that all visitors to our spa complete a consent form for each type of service that is being received in our shop. This form only needs to be completed once and then will be kept on file. Thank you for your patience and understanding.

Facials / Skincare / Waxing

First Name

Last Name

Date of Birth

Do you have any areas of concern, injuries, recent surgery sites, sensitivies, allergies, etc?

Yes

List areas:

Have you ever received professional aesthetic services, facials, waxing, microdermabrasion, microblading, microneedling or dermaplaning before?

Yes

Digital Signature (type your name)

I declare that the info I’ve provided is accurate & complete

I hereby acknowledge this release from liability for accidental injury or illness which I may incur as a result of participating in an aesthetic service. I hereby assume all risks connected therewith and consent to participate in this service. I agree to disclose my physical limitations, disabilities, ailments, or impairments which may affect my ability to receive aesthetic treatments such as facials, waxing, microneedling and dermaplaning, . I understand that aesthetic services are not a replacement for medical treatment and are completed by a state licensed aesthetician and not a dermatologist.

Thanks for submitting!

West End Salon & Spa

155 Commercial Street, Provincetown, MA 02657

Established 1982

The premier location for salon and spa services on Cape Cod

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Consent Forms

Massage

Facials / Skincare / Waxing