Indoor UV tanning is associated with skin cancer. This study describes consumer health risks information provided by indoor UV tanning facility operators in four states (Colorado, Illinois, Texas, and Wisconsin) with varying operator training, regulations, enforcement and penalties. Using a cross-sectional survey study design, 100 randomly selected licensed indoor UV tanning facilities from each state were surveyed anonymously by telephone. Facility operators were questioned regarding the provision of information on potential adverse effects of indoor UV exposure. Of 628 licensed indoor UV tanning facilities contacted, 400 facilities were surveyed. Most (87%) advised patrons of the potential risk of sunburn from indoor tanning. Less than half of facility operators in Colorado, Texas and Wisconsin informed patrons about the risk of skin cancer (42, 43 and 48%, respectively) compared with 81% of Illinois operators. Likewise, more operators in Illinois reported the risk of premature aging (79%) compared with other states (41% Colorado, 43% Texas and 51% Wisconsin). Tanning facility operators frequently misinformed patrons of indoor UV exposure risks. The provision of informed consent by indoor tanning facility operators needs improved adaptation by the tanning industry as a standard for customer service.