Smooth Exposure

Consent & Information Form

By filling out the form below and checking off the 4 "I agree" boxes (and clicking the 'Submit' button), you avoid having to do this at your first tanning appointment. So you can walk right in and get tanned !!

First name: Last name:

Address:

City: State: Zip Code:

Telephone #s - Home: Cell: Work:

E-Mail Address:

I prefer to get an appointment reminder call on

My Home Phone:
My Cell Phone:
Or My Work Phone:

Gender:

Date of Birth:


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How did you discover Smooth Exposure?

Consent and Waiver for Tanning Services

I authorize Smooth Exposure and its trained, authorized representatives to perform spray tanning procedures for my benefit. Yes, I agree:

Undergoing this service may cause individual sensitivities, such as drying of the skin, aggravation to those prone to asthma or allergies even in clients with no prior history of adverse reactions. We are not able to provide services if you are pregnant (in the 1st trimester), have asthma, have broken skin, inflammation, suspicious growths, active herpes or any communicable diseases, are using Accutane or any related product or if we feel that the services could be potentially harmful. Yes, I agree:

The self tanning process involves a turbine air flow system that a technician uses to spray your entire body. Due to the sensitive nature of this service, men are required to wear underwear, a bathing suit, a fabric “pouch” or a paper disposable brief provided by Smooth Exposure. While it is our highest priority to make you feel as comfortable as possible, the process requires you to stand facing the technician with your legs apart and arms out to the side. For women, we will ask you to lift your breasts and for both men and women we ask you to show the inside of each of your legs. If too much product is applied in one area, we may need to sponge the area and gently dab off the excess and reapply. If you are not comfortable with this process, you should not proceed. Yes, I agree:

The active ingredient in the spray is DHA20 (Dihidroxyacetone), which is a natural substance derived from sugar beets. DHA20 works with the amino acids in the skin, causing a chemical reaction that turns the skins upper layers to brown. This reaction occurs in the upper layer of the skin so with natural exfoliation, the tan will fade away gradually over the following 7 days for most people.

Prior to having Smooth Exposure perform this service, consider the following:

* Completely exfoliating before applying and re-applying will enhance the results. Do not use an oil based exfoliant.

* Certain medications including female hormone replacement therapy (Premarin) or anti-depressants could inhibit self tanning.

* The bronzing agent in the tanning solution may stain silk and leather so please do not wear either of these types of fabrics for 12 hours following the application or until you have thoroughly showered.

* Let the application dry for at least 5 minutes before you get dressed following the application. The technician can help you with this process if necessary.

* The tan will develop gradually during the 6 to 8 hours after you have been sprayed. Do not shower for at least 6 to 8 hours following the application. During your first shower you will notice a tea color in the water; this is the bronzing agent that acts as a color guide during the process coming off and the remaining color on the skin is the result of the DHA20 action on your skin.

* It is best not to exercise right after the application as sweating can displace the product and cause your sweat to look a brown color. You may resume exercise after you have taken an initial shower 6 to 8 hours after the application of the tan.

* To make the tan last longer, be sure to moisturize adequately and avoid products containing alpha hydroxy acids as they accelerate skin exfoliation.

I have had sufficient opportunity to read and understand the potential complications of a spray tan. I have reviewed all of the information at Smooth Exposure’s website, including this form, and all of my questions have been answered to my satisfaction and I accept the risks and sensitivities involved with this service. I understand the procedure and believe I have adequate knowledge upon which to base an informed consent. I release Smooth Exposure LLC, and its representatives harmless from any and all claims and damages associated with this service. Yes, I agree:

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