Consultation & Consent | BrowsByKalli

01

Client details

Use the same contact information as your appointment.

Full name Date of birth Mobile numberInclude country code, such as +1 Email Service

02

Health and skin screening

Answer every Yes or No question. Add details whenever you answer Yes.

Are you taking medication that may affect your skin or healing?

Yes No

If yes

Do you have allergies, sensitivities, or previous reactions to wax, tint, adhesive, or skincare products?

Yes No

If yes

Have you used AHA, glycolic acid, a peel, or another strong exfoliant in the last 72 hours?

Yes No

If yes

Have you used a retinoid or isotretinoin such as Retin-A or Accutane in the last 6 months?

Yes No

If yes

Are you using another skin-thinning product or medication?

Yes No

If yes

Are you currently receiving, or have you previously received, cancer treatment?

Yes No

If yes

Do you have diabetes or another condition that can affect healing?

Yes No

Do you have a sunburn, recent tanning, or significant recent sun exposure?

Yes No

Have you had a facial, peel, laser treatment, microdermabrasion, or similar service in the last 14 days?

Yes No

If yes

Other illness, condition, treatment, or skin concern Kalli should know about

03

Consent and signature

Read the statement, then sign with your finger, mouse, or stylus.

I confirm that the information I provided is accurate and complete. I understand that brow and beauty services can cause temporary redness, tenderness, irritation, skin lifting, bruising, burns, or allergic reaction, depending on the service and my individual skin response.

I have disclosed medications, treatments, allergies, and health or skin conditions that may affect the service. I understand that results vary, I may ask questions or stop the service at any time, and this consultation does not replace advice from a licensed medical professional. I authorize BrowsByKalli to perform the service I selected above.

I have read, understand, and agree to the consent statement above.

Draw your signature

Your drawn signature is attached to the emailed form.