Beard Cleanse Mask Application Consent Form
Please review and complete this form to provide your informed consent for the beard cleanse mask treatment.
Please read the following information carefully before proceeding with the beard cleanse mask application. This treatment involves applying a cleansing and nourishing mask to your beard and skin. Inform your practitioner of any allergies, skin conditions, or recent cosmetic procedures.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Do you have any known allergies (especially to skincare products or mask ingredients)?
*
No known allergies
Yes, I have allergies (please specify below)
If you answered yes to allergies above, please specify:
Do you have any current skin conditions (e.g., eczema, psoriasis, dermatitis) in the beard area?
*
No
Yes (please specify below)
If you answered yes to skin conditions above, please specify:
Have you had any cosmetic procedures (e.g., laser treatments, chemical peels) on your face or beard area in the past 2 weeks?
*
No
Yes (please specify below)
If you answered yes to recent cosmetic procedures, please specify:
Signature (please sign below to indicate your informed consent)
*
Submit Consent
Submit Consent
Should be Empty: