Logo

Sunrise Spa - Formerly Paradise Spa

A Full Spectrum Day Spa!

Sunrise Spa Logo

Sunrise Spa
Facial Client Intake Form

If you are visiting first time, complete General Intake Form
If you prefer offline, download: Facial Intake Form PDF
*Have you had reactions to skin care products or cosmetics?
*Do you have any other health concerns we need to know about?
*Select your skin type:

What areas of concern do you have regarding your skin? (Check all that apply)

*When you go out into the sun, do you:

*Have you seen a dermatologist within the past year?

Do you currently use any of the products listed below? (Check all that apply)

*Have you recently received Botox, Restylane, or Collagen injections?

By signing this form, the client agrees to the following:
I understand, have read, and completed this intake form truthfully and agree to inform the technician of any changes in the above information. I agree that this constitutes full disclosure, and that it supersedes any previous verbal or written disclosures. I understand that withholding information or providing misinformation may result in contraindications and/or irritation to the skin from treatments received. The treatments I receive here are voluntary and I release this institution and/or skin care professional from liability and assume full responsibility thereof.

5750 5th Ave N, Saint Petersburg, FL 33710

727-360-4300    www.mysunrisespa.com

Est Lic #MM46057