Daniela Hernandez

Dedicated and passionate Licensed Esthetician with expertise in skincare treatments, facial therapies, and beauty techniques. Skilled in providing personalized skincare consultations and enhancing clients' natural beauty through tailored treatments. Committed to staying updated on the latest industry trends and delivering exceptional customer service.

• Name:
• DOB: Age: Female Male NB
• Phone: Email:
• Emergency Contact & Number
• How did you hear about us?
• Health & Medical History
• Do you have any pre-existing medical conditions or chronic illnesses? No Yes Please describe.
• Are you currently taking any medications or supplements? No Yes If yes, please describe
• Have you had any recent surgeries or medical procedures? No Yes If yes, please describe
• Have you had any allergic reactions to medications or substances in the past? Please describe.
• Do you have any known skin allergies or sensitivities? No Yes If yes, please describe
• Facial & Skincare History
• Have you had any previous treatments or procedures for your face or skin? If yes, please describe
• What specific concerns or goals do you have for your facial or skincare treatment?
• Do you have a history of skin conditions, such as acne, rosacea, or eczema? If yes, please describe.

• I hereby consent to and authorize to perform the following procedure:
• I acknowledge that side effects may occur, and I fully accept this risk. I understand that my Skincare Technician will take every precaution to minimize or eliminate any potential negative reactions. If I experience any complications following my treatment, I agree to consult my Skincare Technician first. I have been given the opportunity to ask questions, and all my concerns have been addressed to my satisfaction.
• I confirm that I have read the provided information and have recorded my medical history accurately, including all pertinent details. For future services, I agree to inform my Skincare Technician of any changes to my medical status or the information provided above. I understand that spa services are not medical treatments, and therefore, the Skincare Technician cannot prescribe medical treatments or pharmaceuticals.
• I understand and agree that my Skincare Technician may determine it is unsafe for me to continue a treatment due to health-related concerns. In such cases, I may be required to provide a medical release from my physician before resuming the treatment.
• I confirm that the information provided above is accurate and complete to the best of my knowledge, and I have not withheld any information that may be relevant to the treatment I am receiving. I accept full responsibility for any side effects that may occur. I consent to the skincare procedure, understanding that it is an elective treatment and no medical claims are implied. I agree to follow the verbal and written aftercare instructions provided to me.
• By signing below, I herby acknowledge that I have completely read and fully understand the above agreement.
• Technician Client Name

• Client Information
• Name:
• Phone:
• Skin Analysis
• Skin type: Normal Oily Dry Sensitive Combination
• Pores: Fine Dilated Comedones Milia
• Moisture content: Excellent Good Fair Poor
• Elasticity: Excellent Good Fair Poor
• Acne: No I II III IV
• Skin sensitivity: Normal Sensitive Hyper sensitive
• Fine lines (Glogau scale): I - None II - Wrinkles in motion III - Wrinkles at rest IV - Mostly wrinkles

• Normal Balances, clear and not sensitive
• Sensitive May burn or itch after using certain cosmetics and skincare products. Can also react with redness
• Combination Drier in some places (mostly cheeks) and oil in others such as T-zone
• Dry Flaky, scaly or rough patches on the face and/or body
• Oil Shiny, greasy looking, most likely to have visible enlarged pores

• Client Information
• Name:
• Phone:
• We kindly request your permission to use these photos for advertising purposes, such as portfolios, online and print ads, and similar materials. Your consent is essential for us to proceed. Please review the options below and indicate your preference by circling the appropriate response and providing your signature. Additionally, we love tagging our clients in photos shared on our Instagram profile! If you’d like to allow or decline this, please let us know by selecting the corresponding option below. Thank you!
• Yes, feel free to use them Yes please tag me on Instagram
• No, please do not use them No, please do not tag me
• Client Signature Date

• Our goal is to provide quality care in a timely manner. To ensure this, we have implemented an appointment and cancellation policy.
• Appointments are in high demand, and canceling early allows another client the opportunity to access timely care. This policy helps us optimize the use of available appointments for all our clients.
• When booking your appointment, you will be required to pay a deposit, which will be applied toward the cost of your treatment(s).
• Time is specifically reserved for your appointment, procedure, or treatment. If you need to cancel or reschedule, you must notify us at least 24 hours before your appointment to retain your deposit or have it applied to a future booking. If less than 24 hours’ notice is provided, the deposit will be forfeited.
• If you arrive more than 15 minutes late for your appointment, it will be considered a no-show, and your deposit will be forfeited.
• We are happy to answer any questions regarding this cancellation policy.
• I have read and fully understand the above Appointment Cancellation Policy and agree to be bound by its terms. I agree to pay the cancellation fee in the event of a missed appointment.
• FULL NAME SIGNATURE