Covering All the Bases: Informed Consent Forms

Written by Susan Preston

The aesthetic industry offers a wide variety of services and procedures. When reviewing a spa menu, it is important to decide when informed consent is needed.


Informed consent is the process by which a spa professional advises a client of the potential benefits and risks involved in the treatment. This enables the client to make a reasonable decision regarding the procedure.




Every treatment has a standard of care, since most spa treatments have been available for many years. The precise requirements of what should be included in the consent may vary throughout the industry; however, failing to obtain an informed consent could create a legal nightmare for the business owner or spa professional.


A claim of lack of informed consent usually accompanies an allegation of professional negligence. The claimant may state they did not know the risks and benefits of the proposed treatment and that, with full information, they would have declined the treatment. Without a signed consent on file, there is no way to refute this allegation.




The important elements of an informed consent include disclosure of expected benefits and risks, as well as any contraindications. The consent must be in writing and signed and dated by the client. If the client is underage, a legal representative must sign on their behalf. Include the printed name of the client and the name of the professional doing the procedure on the consent form.


Place the signed consent in the insured’s file and keep it as long as the statute of limitation in your state requires.


For more complicated or invasive procedures, the consent needs to say there are no warranties or guarantees about the outcome and that the client had the opportunity to explain their goals. Have them acknowledge all their questions have been answered and that they understand the specific risks to the procedures, as well as benefits and alternatives. Only after understanding all of this should they elect to proceed and sign the document.




In lawsuits where there was no informed consent, there is no proof of the discussion between the spa professional and the client. If a client alleges they did not know all the inherent risks, the best defense is a signature on file. It will not necessarily win a lawsuit, but it may dissuade the client from filing one in the first place.


There are some procedures where the industry standard is to not have a consent. This might include hair and nail services. An exception to this could be if the client wants something outside the normal. For instance, they want all their hair cut off except for a blue mohawk. In this case, the salon professional would be advised to get a signed consent because the client may regret an unusual procedure two days later and come back with a request for a refund or worse.


We see this occasionally in the permanent cosmetic industry. For example, a person may want an outlandish eyebrow. In this case, it is advisable to draw the desired shape on a piece of paper and have the client sign off on that same paper stating this eyebrow look is, in fact, what they want and they take full responsibility for determining the shape. Better yet, draw the design on their face, take a picture, and have them sign off on it.




Most spa services use some manner of consent form. It is especially crucial to use forms for any procedure that could be considered a medical or quasi-medical service, including, but not limited to, permanent cosmetics, laser and IPL services, weight loss, and cryotherapy.


Further, there are known issues with tanning units and colon hydrotherapy, so informed consents are called for in those categories. Having microdermabrasion or deep chemical peels just before the client plans a trip to the beach or takes a long bicycle ride in the heat of summer is contraindicated. The informed consent will advise them the waiting period before they can go into the sun or wind.


Massage services need consent forms, since there are so many different types of massage. For instance, hot stone massage will have different issues from deep tissue work. This should always be paired with a massage-specific health history form, as you don’t want to exacerbate an existing problem.


Treat every client who walks in the door, even family or friends, in the same professional manner. Do not assume there is anyone who doesn’t need to sign a consent form, if that is the spa standard. It is often that one person who ends up suing the spa. If people feel they are treated less than professionally, they are more likely to sue the business. Have rigid standards for everyone who comes in the door. And, for the unforeseen client or unexpected program, carry professional liability insurance.





Susan Preston 2019Susan Preston has been at the forefront of insurance program innovation since 1993 when she founded Professional Program Insurance Brokerage (PPIB) in Novato, California. Preston is also the co-founder of a nonprofit association setting standards for the permanent makeup industry, Society of Permanent Cosmetic Professionals (SPCP). With industry involvement, Preston and PPIB have been leaders in insurance programs for emerging markets and for the spa industry. Due to the national reputation of PPIB, in 2016 and 2017, Insurance Business America Magazine named Preston one of the 144 Elite Women in Insurance.

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