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Body Buff
Please fill out the following form
in order to participate in our service.
First name
Last name
Date Of Appointment
Do you have sensitive skin?
Yes
No
Do you currently have any open cuts ?
*
Yes (Please advice tech)
No
By checking the box below, you understand and consent to performing self-administered whitening treatments at Glitz Spray Tanning . You also confirm that you have read and understood this entire agreement, including the potential risks, complications, and side effects, versus the benefits of whitening treatments. You also understand the need for follow-up care and proper maintenance in order to maintain a lighter tooth color shade over time. I understand that I am performing this treatment under my own responsibility and care, and that I must follow all instructions during the process. I certify to the best of my knowledge, that my teeth and gums are healthy and that I am eligible for treatment and hold no responsibility to the Technician at Glitz Spray Tanning
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