Ear Candling - Client Consent and Intake Form

I understand that this ear candling session is for the purpose of stress reduction, health aid or for increased circulation and energy flow. 
It has been made clear to me that this session is not a substitute for medical examination and/or diagnosis, and it is recommended that I see a physician for any physical ailments I may have. By signing this release, I do hereby waive and release Generations Salon & Day Spa, and any and all affiliates, from all liability, past, present and future.

Client Name (please print)__________________________________________________
Client Signature____________________________________________Date__________

Consent to Treatment of Minor
By my signature below, I hereby authorize Generations Salon & Day Spa to administer ear candling to my child or dependent.
Client Date of Birth (If under the age of 18) ___________________________________
Guardian Name (please print) ______________________________Date____________
Guardian Signature________________________________________Date___________