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FFBC Sunless Tanning Intake

Client Information

First name*

Last name*

Email*

Phone

Which of the following services have you had done in the PAST?*

Spray Tan Booth (machine)

Spray Tan (hand sprayed)

Self-tanner (at home)

None of the above

How did that experience go? Did you have any reactions?

Health History

Do you have any known allergies topically to skincare or makeup ingredients, especially to DHA (Dihydroxyacetone) or other tanning agents?*

Yes

If yes, what are you allergic to and what happened?

Are you currently taking any medications?*

Yes

Certain medications can affect your skin's reaction to tanning products.

If yes, please specify:

Are you currently taking Accutane or have you taken it in the past?*

Yes

If yes, how long?

Are you on any other medication?*

Yes

Please list all current or recent medications:

Are you exposed to the sun on a daily/regular basis or do you use a tanning bed?*

Yes

If you are healing from sunburn in the area you intend to have services please let us know.

If yes, how often and when was the last time?

Are you currently pregnant?*

Yes

Unsure

If yes, how far along are you?

Do you have any topical allergies that you're aware of?*

Yes

List of known allergies:

Do you have any existing skin conditions (e.g., eczema, psoriasis) or recent sunburns?*

Yes

If yes, please describe:

Lifestyle

Do you:

use saunas

exercise

sweat excessively

have oily skin

have ingrowns

have body acne

have thick course hair

other

If other, please mention anything you feel is appropriate:

Is skincare important to you?*

Absolutely

Sometimes

Not really

Do you have any piercings or healing tattoos in the area to be serviced?*

Yes

If yes, please specify which, what part of the body, and how large the area affected is:

What skincare products do you prefer to or currently use? Check all that apply.

Body wash (gel/liquid)

Bar of soap

Lotion

Body oil

Body butter

Exfoliators (body or face)

None of the above

other

Please avoid DOVE body wash/body care products for 1-2 weeks before and after service. They leave a film on the skin and create a very patchy and undesirable result for spray tans.

If other, please list:

Preparation and Aftercare

I understand that to achieve optimal results, I should exfoliate my skin and ensure it is free of lotions, perfumes, deodorants, and makeup prior to my tanning session.
I acknowledge that I have received and understand the aftercare instructions provided, which include avoiding water/liquid contact, sweating, and wearing tight clothing for a specified period post-application to ensure even development and longevity of the tan.

By checking this box, I agree to the terms above.

Client Acknowledgement

I request and consent to the application of sunless tanning products to my skin by the trained technicians of Fearless Femme Beauty Company.

I have provided accurate and complete information regarding my health, allergies, medications, and skin conditions. I understand that withholding information may result in adverse reactions.
I agree to inform my technician of any changes to my health status or skin conditions prior to each tanning session.
I understand that the sunless tanning procedure involves the application of a spray tan solution containing DHA, which reacts with the amino acids in the skin's surface layer to produce a tanned appearance.
I acknowledge that results may vary based on individual skin types, preparation, and adherence to aftercare instructions.
I am aware that while sunless tanning is generally safe, there is a small risk of allergic reactions or skin sensitivities.
I acknowledge that results may vary based on individual skin types, preparation, and adherence to aftercare instructions.
I understand that the tanning solution does not contain sunscreen and does not provide protection against UV radiation.
I agree to follow all aftercare instructions provided by Fearless Femme Beauty Company to ensure the best results and minimize potential risks.
I understand that Fearless Femme Beauty Company reserves the right to refuse service to anyone exhibiting symptoms of illness, providing inaccurate information, or not adhering to health and safety protocols.
I consent to the use of photographs or videos taken during my service for promotional purposes, understanding that my identity will remain confidential unless otherwise agreed upon.

By checking this box, I agree to the terms above.

Liability Waiver

I, on behalf of myself and my heirs, hereby release, waive, and discharge Fearless Femme Beauty Company, its owners, employees, and agents from any and all liabilities, claims, actions, or demands arising from or related to the sunless tanning procedure, including any adverse reactions or dissatisfaction with results.

Signature*

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Date*

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Day

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1197 N. East Street Frederick, MD 21701