I have voluntarily elected to undergo this Skin Care Procedure(s) after the nature and purpose of this procedure have been explained to me.
I understand and acknowledge that there are risks involved with the procedure i will be receiving. Although it is impossible to list every potential risk and complication, I have been informed of possible benefits, risks and complications. I have had the opportunity to ask questions regarding these risks and other possible complications.
I also recognize there are no guaranteed results and independent results are dependent on age, skin condition and lifestyle. There is also a possibility that I may require further procedures of the treated areas to obtain the expected results at an additional cost.
I have read and understood the post-procedure home care instructions. I understand how important it is to follow all instructions given to me for post-procedure care. In the event that I may have additional questions or concerns regarding my procedure or suggested home product/post-procedure care, I will consult my Aesthetician immediately.
I have also, to the best of my knowledge, given an accurate account of my medical history, including all known allergies or prescription drugs or products I am currently ingesting or using topically.
I have read and fully understand this agreement and all information detailed above. I understand the procedure and accept the risks. I agree I will assume the risk and full responsibility for any and all injuries, losses, side effects or damages that might occur to me while I am undergoing this skincare procedure. I do not hold the Aesthetician, whose signature appears below, responsible for any of my conditions that were present, but not disclosed at the time of this skincare procedure, which may be affected by the procedure performed today.
