Consent Form

Date: May 27, 2025

Client Information

Name: ________________________________________
Phone Number: _________________________________
Email Address: _________________________________
Date of Appointment: __________________________
Service(s) Booked: __________________________

Health and Skin Disclosure

Please answer the following (✓ or ✗):
– Do you have any known allergies (cosmetic, skin, hair, etc.)? ____
– Do you have any existing skin conditions (e.g., acne, eczema, rosacea)? ____
– Are you currently on any medication for skin/hair? ____
– Do you have any recent cosmetic treatments (Botox, peels, etc.)? ___

If yes to any of the above, please provide details:
__________________________________________________________
__________________________________________________________

Consent and Acknowledgment

By signing this form, I acknowledge the following:

1. I have disclosed all known allergies, medical conditions, and relevant skin/hair history.
2. I understand that results may vary based on individual skin and hair types.
3. I will not hold Diya Sharma Makeup & Hair Studio or its staff responsible for any allergic or adverse reactions resulting from the service(s) provided.
4. I understand that makeup and hairstyling are temporary cosmetic enhancements.:
5. I give consent for photographs to be taken before/after services (optional) for portfolio or social media use. [Yes / No]

I confirm that I have read and understood the above, and I consent to receive the selected services.

Client Signature

Signature: ___________________________   Date: ________________

Studio Use Only

Staff Name: __________________________
Notes: ________________________________________________________
_______________________________________________________________