BEFORE YOUR TAN

• Please shower, shave & exfoliate your skin. You MUST exfoliate with a non-abrasive exfoliant, preferably Infinity Sun pineapple enzyme Exfoliant. (If you use a salt or beaded exfoliant within 72 hours prior to airbrushing, it will create small spots and unevenness when the tan begins to fade.)

• Additional salon & spa services (hair, facials, massages, manicures, pedicures, and waxing) should be done prior to tanning.

• Avoid anything containing alcohol or oils the day of the tan. DO NOT use lotion, deodorant or perfume.

• You shouldn’t shower after your spray tan – the solution is active for 12 hours so the longer you leave it on, the darker and longer lasting your tan will be.

• Our female guests may choose to tan nude, however we require our male guests to wear boxers. We provide all necessary disposable undergarments, or you may choose to wear your own. The tanning solution is water soluble and will wash off clothing if laundered within a few days.

AFTERCARE

• Pat (DON’T RUB) to dry off after showering.

• Avoid sweating or getting any moisture on the skin for a minimum of 12 hours.

• Hydrate with water based moisturizers; it is recommended you only use Infinity Sun extenders. Please note, if you choose not to use Infinity Sun maintenance products we cannot guarantee the quality or longevity of your tan.

• Avoid swimming and acne products.

• Cosmetic airbrush tanning DOES NOT provide sun protection. You must wear sunscreen to prevent burning during prolonged UV exposure.

(203) 269-0636 www.msalonandspa.com

Recommended Preparation & Maintenance Products

Infinity Sun Exfoliant: We strongly recommend this pineapple enzyme body scrub prior to tanning to maximize your results by gently removing dead skin cells. Please note: if you choose to use an alternate exfoliating product, it must be used 72 hours PRIOR to tanning.

Infinity Sun Extend: This water-based moisturizer helps extend the life of your tan. It also contains a small amount of DHA, which is great for touchups. Grapefruit scent.

OR

Infinity Sun Extend with Shimmer: Same great extender, this moisturizer adds fine mica particles to give your skin a radiant, opalescent glow!

Infinity Sun Glow on the Go: Great touch up for the hands, feet, and face between tans. Also great for quick all over color that you can do yourself! This touch up aerosol is an amazing vanilla smelling bronzer with DHA that lasts up to 5 days, and will achieve the same color as your spray tan.

(203) 269-0636 www.msalonandspa.com

Name: ______Date of Birth:______Emergency Contact:______Relation:______Phone:______

Medical History 1. Are you currently under medical supervision? Yes or No If yes, please explain______2. Do you see a chiropractor? Yes or No If yes, how often? ______3. Please list any medications, supplements, vitamins, diuretics, slimming tablets, etc. that you are currently taking: ______4. Within the last nine months, have you undergone surgery? Yes or No If yes, please specify______5. Do you smoke? Yes or No 6. Do you have diet restrictions? Yes or No If yes, please specify ______7. Do you wear contact lenses? Yes or No 8. Do you have metal implants, a pacemaker or any body piercings? Yes or No If yes, please specify______9. Please check any conditions that are listed below that applies to you: ( ) Contagious Skin Condition ( ) Phlebitis ( ) Emotional Difficulties ( ) Open Sores or Wounds ( ) Deep Vein Thrombosis ( ) Lymphatic Condition ( ) Blood Clots ( ) Easy Bruising ( ) Atherosclerosis ( ) Joint disorder / Arthritis / Tendonitis ( ) Recent accident or injury ( ) Varicose Veins ( ) Osteoporosis ( ) Recent fracture ( ) Circulatory Disorder ( ) Epilepsy ( ) Recent Surgery ( ) Carpal Tunnel Syndrome ( ) Headaches/Migraines ( ) Artificial Joints ( ) High / Low Blood Pressure ( ) Cancer (Active / Remission) ( ) Diabetes ( ) TMJ ( ) Current Fever ( ) Strains/ Sprains ( ) Heart Condition / Disease ( ) Decreased Sensation ( ) Back/Neck Problems ( ) Fibromyalgia ( ) Allergies/Sensitivities ( ) Acute Illness ( ) Rheumatoid Arthritis ( ) Renal Disease ( ) Psoriasis Please explain any condition that you have marked above: ______10. Are you pregnant? Yes or No If yes, how many weeks? ______11. Is there anything else about your health history that would be useful to plan a safe and effective service? ______

Please fill out the following sections that apply to your services: Massage: Section 1 Facials & Body Treatments: Section 2 Body Wax: Section 3 Airbrush Tanning: Section 4

Section 1: Massage 1. Do have specific goals for your massage? ______2. What is your previous experience with professional massage? ______How often do you receive massage services? ______3. Name of Healthcare Provider: ______Town: ______Phone: ______4. Do you have any allergies to oils, lotions, or ointments? Yes or No If yes, please explain______5. Essentials oils are used for some services and can be powerful. Initial: ______6. Do you have sensitive skin? Yes or No 7. Are you currently wearing: ( ) contact lenses ( ) dentures ( ) a hearing aid

8. Do you exercise? Yes or No If yes, how many times a week? ______9. Do you experience stress in your work, family or other aspects of your life? Yes or No If yes, do you think it has affected your health? Yes or No ( ) Muscle tension ( ) Anxiety ( ) Insomnia ( ) Irritability ( ) Other: ______10. What do you do to relax? ______11. Are there particular areas of the body where you experience tension, stiffness, pain or other discomfort? Yes or No If yes, please identify______12. Draping will be used so that only the area being worked on will be uncovered. Clients under the age of 17 must provide written consent by parent or legal guardian. Initial______

Hot Stone Massage The following section only applies to guests receiving Hot Stone Massage: 1. Have you experience hot stone massage therapy before? Yes or No 2. The stones are warmed in a hot stone warmer to 130°F. I am comfortable with this temperature? Initials: ______

Massage Cupping Bodywork Therapy The following section only applies to guests receiving Massage Cupping Bodywork Therapy: 1. Massage cupping bodywork therapy is used to soften tight muscles, loosen adhesions and lift connective tissue in order to increase blood flow to body tissues. This will drain excess fluids and toxins by opening lymphatic pathways. Initials: ______2. There is a possibility of skin discoloration, known as “Cup Kiss,” as a result of this procedure. Initials: ______3. “Cup Kiss” is not a bruise and should dissipate in a few hours. Please note, it can also take as long as a few days or weeks to disappear. Initials: ______4. After Massage Cupping Bodywork Therapy, please avoid hot showers, steam saunas and exercise. Initials: ______5. You are strongly advised to drink plenty of water following this treatment to hydrate the tissues. Initials: ______

Section 2: Facials & Body Treatments 1. Have you been under the care of a dermatologist in the past year? Yes or No 2. Do you have any specific skin problems? Yes or No If yes, please explain: ______3. Please check the following facial product(s) that you are currently using: ( ) Soap ( ) Cleanser ( ) Toner ( ) Moisturizer ( ) Masque ( ) Exfoliant ( ) Eye Cream ( ) Self Tanner ( ) Sunscreen 1. Please check the following body product(s) that you are currently using: ( ) Soap ( ) Shower Gel ( ) Scrub ( ) Oil ( ) Moisturizer ( ) Depilatories ( ) Self Tanner ( ) Sunscreen 2. Have you ever had chemical peels, microdermabrasion or any resurfacing treatments? Yes or No If yes, when was your last treatment? ______3. Do you use Accutane, Retin-A, Renova, Adapalene or any other prescription skin products? Yes or No In the last three months? Yes or No 4. Are you currently using any products that contain the following ingredients? ( ) Glycolic acid ( ) Lactic acid ( ) Exfoliating scrub ( ) Hydroxy acid ( ) Vitamin A Derivatives 5. How much plain water do you consume daily? ______6. How many alcoholic beverages do you consume daily? ______7. Do you ever experience the following skin conditions? ( ) Flakiness ( ) Tightness ( ) Obvious dryness 8. Do you sunbathe or use tanning beds? Yes or No 9. Do you burn easily in moderate sunlight? Yes or No 10. Do you blush easily when nervous? Yes or No 11. Do you have tendency for redness? Yes or No 12. Do you suffer from sinus problems? Yes or No 13. Do you experience oily shine during the day? Yes or No 14. Do you experience skin breakouts? Yes or No 15. Do you drink more than four caffeinated beverages per day? Yes or No 16. Do you ever experience a burning and/or itching sensation on your skin? Yes or No 17. What is your pain threshold? ( ) Low ( ) Average ( ) High 18. Have you ever experienced claustrophobia? Yes or No 19. What type of massage pressure do you prefer? ( ) Light ( ) Medium ( ) Firm 20. Have you ever had an allergic reaction to the following: ( ) Cosmetics ( ) Medications ( ) Iodine ( ) Pollen ( ) Foods ( ) Hydroxy Acids ( ) Animals ( ) Sunscreen ( ) Fragrance ( ) Other ______21. Have you had any recent dental x-rays? Yes or No FEMALE CLIENTS ONLY MALE CLIENTS ONLY Are you taking oral contraception? Yes or No What is your current shaving system? Are you pregnant or trying to become pregnant? Yes or No ( ) Electric ( ) Blade Are you lactating? Yes or No Do you experience irritation from shaving? Yes or No Are you currently having or due for your menstrual period? Do you experience ingrown hairs? Yes or No Yes or No

Section 3: Body Waxing 1. Have you ever been treated for cancer? Yes or No 2. Have you used Alpha Hydroxy Acid or Glycolic products in the past 48-75 hours? Yes or No 3. Are you currently using Retin A, Renova or Accutane? Yes or No 4. Are you using any skin thinning products and/or medications? Yes or No 5. Do you get daily UV exposure or are you considering more UV exposure soon? Yes or No 6. Do you use tanning beds? Yes or No If so, how often? ______7. Have you had cosmetic facial injections within the last 24 hours? Yes or No 8. FEMALE CLIENTS, what was the date of your last menstrual cycle? ______9. Please note that waxing can have side effects such as skin removal, redness, swelling, tenderness, etc. Initials ______

Section 4: Airbrush Tanning To help you best achieve your desired results, please read and initial each of the following: 1. Infinity Sun Airbrush Tan WILL NOT prevent your skin from burning. You must take the proper precautions when exposed to UV light. Initials: ______2. The Infinity Sun Airbrush Tanning System is designed to provide as even a tan as possible. Please note, skin porosity varies and may affect results and longevity. You may find some areas tan lighter than others, but in most cases, these differences are minor and disappear after several sessions. Initials: ______3. Please note, if you have ever experienced adverse effects utilizing self-tanning products or moisturizers you will probably experience similar effects with this system. Initials: ______4. All the ingredients in the Infinity Sun Solution are FDA approved for use as a self-tanning skin agent. If you choose, you may request protective coverings from your technician. Initials: ______5. Please consult a physician if you have any history of asthma or respiratory conditions that could be aggregated by the use of the Infinity Sun Airbrush Tanning System. Initials: ______6. The Infinity Sun Bronze Solution contains nut/peanut extracts; please immediately notify your technician if you have any type of allergy to peanuts and/or nuts. Initials: ______7. Use of sunless tanning agents causes blood sugar levels to rise. Please consult with your physician before using the Infinity Sun Airbrush Tanning System if you have a diabetic condition. Initials: ______8. I acknowledge I am using these services at my own risk. I hereby authorize and direct my technician to perform such procedures as may be deemed necessary or advisable, and have provided them with all the above information required. I hereby relieve Infinity Sun and M. Salon & Spa and hold them harmless from any liability involved in the use of the airbrush tanning process/products. M. Salon & Spa and our agents are not liable for any injury to person or property or the loss or theft of any personal property. Initials: ______9. I have been made aware that M. Salon & Spa reserves the right to cancel any package or session without reimbursement for customers who are verbally abusive, act in an inappropriate manner, do not adhere to our salon and spa policies, and/or act in a destructive or harmful manner. Initials: ______

Please Read and Sign at every visit: I confirm that the answers I have given are correct and that I have not withheld any information that may be relevant to my treatment(s). I affirm that I have stated all my known medical conditions and answered all questions honestly. I agree to keep M. Salon & Spa updated to any changes in my medical profile. I understand that I am undergoing treatments under my own request and will not hold M. Salon & Spa liable. Signature:______Date:______Signature:______Date:______Signature:______Date:______Signature:______Date:______Signature:______Date:______Signature:______Date:______Signature:______Date:______Signature:______Date:______