Client Health History

Health History

Selected Value: 0
Selected Value: 0
Selected Value: 0
Selected Value: 0

I understand, have read, and completed this questionnaire truthfully. I agree that this constitutes full disclosure, and that it supersedes any previous verbal or written disclosures. I understand that withholding information or providing misinformation may result in contraindications and/or irritation to the skin from treatments received. I am aware it is my responsibility to inform Melissa Williams, my esthetician, of my current medical or health conditions and to update this history. The treatments I receive here are voluntary and I release Melissa Williams/Oly Skin & Wax from liability and assume full responsibility thereof.

Although every precaution will be taken to ensure your safety and well-being before, during, and after your treatment/procedure, please be aware of the following information and possible risks and indicate that you fully understand what to expect. Please check: