Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Emergency contact name and phone number:

How did you hear about us?

Health History:

Do you Smoke?

Are you currently using blood thinners?

Do you use hand lotion with sun block?

Are you diabetic?

Please list any known allergies:

Do you have any broken skin on the hands or feet? Yes or No If Yes, Please Explain

Are you pregnant? Yes or No If yes, which trimester?

Have you ever had an allergic reaction to any type of nail enhancement or other nail related product? Yes or No If Yes, Please Explain

Have you ever experienced a nail infection of any sort? Yes or No If Yes, Please Explain

Do you have, or have you had, a history of:

Diabetes

Heart Disease

Thyroid Problems

Circulatory or Muscular Disease

Hypertension

Cancer

Allergies

Other

Sensitivity to any cosmetic ingredients

Health History

I have recorded my medical history accurately with all pertinent information. For future services, I agree to inform my salon technician of any changes in my medical status and/or the above information. I agree to hold Nailbed & Bar, LLC (also referred to as Nailbed & Bar) and its employees, contractors and associates harmless for the performances of these services. I understand salon services are not to be considered medical treatment, and as such, the salon technician/professional cannot prescribe treatment of pharmaceuticals. I understand that any comments or behavior deemed inappropriate by the service provider (illicit or sexually suggestive in nature) will result in the immediate termination of the session and I will be liable for payment of the scheduled service. Cancellation policy: In order to provide optimal scheduling for all guests, Nailbed & Bar finds it necessary to implement a 24-hour cancellation policy for all appointments.

Alcohol Waiver

Alcohol will be available on the premises. Individuals under the age of 21 are prohibited from obtaining or consuming any alcohol at any point during service. I expressly affirm my acceptance of full responsibility for complying with all applicable laws regarding consumption of alcohol, and if consuming alcohol, monitoring and/or limiting my alcoholic beverage intake. By accepting alcohol during my service, I warrant that I am at least 21 years of age. I hereby expressly release Nailbed & Bar from any liability for damages incurred by me or any other person or entity caused in whole or in part by my consumption of any item, including without limitation, alcohol.

COVID-19 Waiver

I agree that I will not hold Nailbed & Bar and any team members or patrons liable for any injury, illness or health related condition that arises following my service. I also agree, should I contract COVID-19, I will notify management of Nailbed & Bar immediately in accordance with contact tracing guidelines in place for Washington, DC. To prevent the spread of contagious viruses and to help protect each other, I understand that I will have to follow the salon's strict guidelines. I understand the COVID-19 virus has a long incubation period during which carriers of the virus may not show symptoms and may still be contagious. I confirm that I am not presenting any of the following symptoms of COVID-19: temperature above 100.4 degrees, shortness of breath, loss of sense of taste or smell, dry cough, or sore throat. I understand, read, and completed this questionnaire truthfully. I agree that this constitutes full disclosure and that it supersedes any previous verbal or written disclosures. I understand that this document is to provide the best possible guest experience when visiting the salon. I hereby waive all claims and forever release Nailbed & Bar, including its officers, directors, employees, successors, assigns, agents, heirs, representatives, and volunteers as applicable, in their individual or corporate capacities, of all claims, liabilities, agreements, and causes of action of any nature due to any injury, loss, or damage to person or property, that may arise out of my services performed at Nailbed & Bar.

Guests Consultation Form

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