Gift Certificate This Gift Certificate Entitles Bearer to _

Gift Certificate This Gift Certificate Entitles Bearer to ______________________________________________ To be provided by ______________________________________________ Please call _______________ to arrange an appointment and for further information. Expires_____________ Authorized By_________________________ A Gift Certificate is an avenue to sell your services from the salon and serves as a means of providing the needed funds. RELEASE STATEMENT It is important to have a signed statement before performing your service. Such is standard practice in well managed beauty establishments. Prepare accordingly or as sample shown below. INFORMED CONSENT Name of Patient_______________________Address______________________________________________ Health Care Facility____________________________ Address______________________________________ I fully understand that the (cosmetology, esthiology or nail technology) services which I have requested and am about to receive is ordinarily harmless to me or to normal (hair, skin, nails). I accept respo==nsibility for adverse reactions (allergic, etc.) that may result, directly of indirectly to me or my (hair, skin, nails). Bed Person/Family member: ____________________________________Date_____________________ Signature Authorized & witnessed by:____________________________________Date_________________ Signature S A M P E L Establishment Your Name Here INDEPENDENT CONTRACTOR - DOING BUSINESS AS (D/B/A) Phone your local newspaper requesting to speak with someone in the Classified Department. Ask the person to send you a Fictitious Name Registration Form - D/B/A. Complete and return it to the newspaper with the required fee. They will publish your fictitious name, perhaps several times during the month. Then, you will receive exclusive rights to your business name. If you choose to use your name, you might need a lawyer. If your name is Karen Ryan for example, try Karyan (fictitious) Beauty Caregiving Services. In the meantime, prepare brochures and business cards at your local printer. Below are samples for your use. SAMPLE BUSINESS CARD LAYOUTS These samples are currently being used by beauty caregivers and can be modified at your discretion to suit your needs. Standard Business Card Copy of your lapel pin here (333)123-4567 Mane Street Salon (Cosmecaregiving,Esthecaregiving, Nailtekcaregiving) o f BEDPATIENTS Registered Cosmecaregiver Julie Ryan Fold-Over Business Card Printed 2 Sides Outside Inside 1Fold S Registered CosmeCaregiver A M • • • • • • 1234 SW 23 St. Anywhere, USA 33315 P E L • • • • • • CHOOSE TITLE I Specialize in: Fold Your Appointment is on: _________________________ at _________________am/pm If unable to keep your appointment please call 24 hours in advance to cancel. (Cosmecaregiving,Esthecaregiving, Nailtekcaregiving) o f BEDP ATIENTS Julie Ryan Mane Street Salon 1234 SW 23 St. Anywhere, USA 33315 (333)123-4567 CHOOSE TITLE Cosmetology In-Patient Care In-Bed Hair & Scalp Cleansing & Rinsing. Medical level technique simplicity and therapeutic results, can greatly help patient's recovery, improve their self-esteem and complement bedside nursing when in: Introducing • Hospitals • Rehabilitation Centers • Nursing Homes • Hospice • In-Home Patient Ladies Services • Shaping & Trimming Hair • Partial Bed Perm • Haircoloring & Hairlighting • Formal Facial • Formal Manicure • Formal Pedicure • Selected Mini-Styles • Wig & Hairpiece Care • Consultation & Maintenance S A M • Facial Shaving • Eyebrow Shaping • Beard & Mustache Trimming • Camouflage Style P E L Male Services Area for Personalization State Licensed in Cosmetology, Insured & Nationally Registered Cosmecaregiving Registry # GIFT CERTIFICATES AVAILABLE Desairology Services Available Sample of data form - size as needed Cosmecaregiving Appointment & Fee Name of patient:____________________________ Date of Service:___________ Time:_______ print Name of person requesting service (other than person listed above): ___________________________ Health Care Facility - Patient Residence Name:___________________________ Section:_______ Floor:___ Rm# ___ Tel#___________ Address:____________________________________ City: ___________________ St:_________ Medical permission Assistant available Known condition Skin:_________ Nails: ______ Reviewed services listed below with requester Products to be used: Provider Patient _____________________________________________ list products Accessory Service Hair Shaping Hair Trimming Haircoloring Hairlighting Partial Perming Formal Facial Formal Manicure Formal Pedicure Eyebrow Shaping Consultation & Maintenance Crafted Wig, Hairpiece Male Services Authorization: client-patient assigned nurse family _______________________________ signature S Facial Shaving Beard & Mustache Trimming Eyebrow Trimming A M P E L Fee: Fee: Fee: Fee: Fee: Fee: Fee: Fee: Fee: Fee: Fee: Fee: Fee: Cash Fee: Fee: TOTAL: Check #_____________ Credit Card #________________________ Expire Date ____/____ Next appt:__________ Time:_______ day/month/year As a courtesy to our clients and cosmecaregiver, appointments must be cancelled 24 hours in advance. She/he will check prior to leaving our establishment for confirmation of the appointment. Sample of data form - size as needed Cosmecaregiver Service Record print Area for Personalization Name of Patient: ___________________________ Date of Service:___________Time:________ day/month/year Name of Person Requesting Service (other than person listed above): ________________________________ Health Care Facility - Patient Residence Name:_____________________________Section:______Floor ____Rm#____ Tel.#__________ Address:________________________________________City:__________________ St______ medical permission assistant available known allergies lesion(s) Service Rendered: o Formal Pedicure Facial Shaving list each product o Shaping o Formal Facial o Formal Manicure Partial Perm Beard Shaping provider Haircoloring Mustache Trim patient Hairlighting Eyebrow Trim Source of Product Used: facility: ____________________________ ___________________________________________________________________________________________________ Objective/Subjective Comments:_____________________________ S A M P E L Wig Hairpiece Signature: ______________________________ Cosmecaregiver Assistant Next appointment ____________________________________ day/month/year