Esthetician consent formfor facials, peels and devices
A facial and a chemical peel carry very different risks, but both touch skin that reacts to sun, medication and active ingredients. This consent covers the range of a skin care menu, with an extra paragraph for laser, IPL and similar devices.
Skin care service consent
The same wording clients sign in Luvira. Copy it and adapt it to your services and your state.
Skin care service consent
Depending on the service, we cleanse, exfoliate, perform extractions and treat your skin; this may involve active ingredients (such as acids) and devices.
Possible reactions: redness, warmth, tightness, small scabs after extractions and temporary breakouts. Peels can cause flaking. Allergic reactions to ingredients are rare but possible.
We do not treat active skin infections, open wounds or an active cold sore, or if you have recently taken certain medications (such as isotretinoin) — please let us know.
Aftercare: no tanning beds, sauna or intense sun for 24 to 48 hours; use sunscreen during the day. Do not pick at scabs.
Treatments with lasers, IPL or similar devices can additionally cause pigment changes, blistering and, rarely, scarring; avoid sun exposure before and after.
Please contact us if anything feels unusual after your treatment — strong pain, lasting redness, swelling or signs of infection. The sooner we know, the easier it is to help.
We cannot guarantee a specific result: skin, hair and healing differ from person to person. We work to the best of our professional knowledge and have explained the procedure, risks and alternatives to you. You had the opportunity to ask questions, and your questions were answered.
Questions to add to your intake form
Are you using retinoids, acids or other exfoliating products, and when did you last use them?
Have you taken isotretinoin in the past months?
Have you had sun exposure, a tanning bed or self-tanner on the area recently?
Do you get cold sores, and do you have one now?
Have you had a peel, microneedling or laser treatment recently?
Do you have rosacea, eczema or another skin condition in the area?
One menu, many risk levels
A basic facial rarely causes more than redness. A peel can make skin flake for days, extractions leave small scabs, and device treatments can shift pigment or blister. A single consent can still work if it describes reactions by treatment type, so the client sees what applies to the service she booked.
The intake questions that matter most
Most problems in a skin studio start with something the client did not mention: an acne medication, a retinoid used the night before, a weekend at the beach. Ask about these directly and recently — not just “any medications?” — and you will catch them before the treatment instead of after.
Template, not legal advice. Consent requirements differ by state and by service — check your state board’s rules and have the wording reviewed before you use it.
More for estheticians
Other specialties
Frequently asked questions
About consent forms for estheticians
The template covers peels within the skin care consent. If your state or insurer expects a peel-specific form, use this text as a starting point and add the product details.
Devices such as lasers and IPL are regulated differently from state to state, and in some states they need medical supervision. Check your state’s rules before offering them.
No, not yet. Luvira uses this exact wording as a fixed template and stores the version with each signature. Copy it here if you need to adapt it.
In Luvira, yes — clients sign on their own phone or on a tablet in your studio, and the signed version is kept with their client record.
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