First-Time Client Release of Information
Welcome to Anaïs Aura Aesthetics.
To provide you with the safest and most effective treatments, please complete this confidential form before your service. Your information helps me understand your needs, identify any health considerations, and customize your experience.
All information is strictly confidential and will not be shared.
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Full Name *
Date of Birth *
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Phone Number *
Email Address *
Emergency Contact
Current Medications *
Allergies *
Pregnant or Nursing *
Recent Surgeries *
Skin Concerns/Conditions *
Consent and Release - I understand that treatments at Anaïs Aura Aesthetics are for cosmetic and relaxation purposes only, and not a substitute for medical care. *
Consent and Release - I confirm that the information I have provided is accurate, and I will update my esthetician of any changes to my health. *
Full Name as Signature *
Date *
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