Your answers will better help us to meet your needs and ensure that you have a happy and satisfying experience.
This information is to ensure we carry out the appropriate treatments for you, taking into consideration any medical conditions which might have treatment contraindications.* Female clients only
If yes please specify the date you received your last treatment
I acknowledge that side effects can occur and I fully accept the risk. I understand that my technician, will take every precaution to minimize or eliminate negative reactions as much as possible. I will consult my technician first should I have any complications after receiving my treatment. I have been given the opportunity to ask questions and any questions have been answered to my satisfaction.
I have read the information and recorded my medical history accurately with all pertinent information. For future services, I agree to inform my technician of any changes in my medical status and/or the above information. I understand spa services are not considered medical treatment, and as such, the technician cannot prescribe treatment of pharmaceuticals.
I agree that my technician may determine that it is unsafe for me to continue a facial session due to health-related concerns. In this event I may be required to provide a medical release form from my physician prior to continuing treatment.
I confirm that the information given above is correct, and that to my knowledge, I have not withheld any information that may be deemed relevant to the treatment I am receiving. I acknowledge that there are potential risks and complications to receiving any procedure, and I take responsibility for any side effects should they occur. I consent to the facial & skin treatment with the understanding that it is an elective procedure, no medical claims are expressed.
I certify that I have read and fully understand the above paragraphs, that I have had sufficient opportunity for discussion and to ask questions, and that I hereby consent to the procedure described above.
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