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  • Skin Health & Lifestyle Assessment

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  • Your Medical History

  • Declarations & Acknowledgements

    Appointments and Cancellations

    I acknowledge that I must adhere to Charlotte Rye Aesthetics policies.

    I understand that cancellations must be made with at least 48 hours notice.  

    I acknowledge that ANY No-Show will result in the loss of a single treatment from a pre paid course or 100% of the total service cost.

    I understand that if I arrive late for my appointment it may be subject to cancellation or to a reduced treatment time and I will be responsible in accordance with the “No-Show” policy.

    After Treatment Skincare

    I acknowledge that my skin might experience temporary irritation, tightness, redness or slight swelling which usually dissipates within 72 hours depending on skin sensitivity. 

    I agree to follow the after care given to me and acknowledge that failure to do so could result in an adverse reaction and have a negative effect on the results of my treatment.

    I acknowledge that if I am allergic to one or more ingredients in the products used, I may experience allergic reactions.

    I acknowledge that I must use a skin protection product SPF 50 after my treatment and for a minnimum of 72 hours post treatment.  If I fail to use a minimal sunscreen (SPF 50), I am more susceptible to sunburn, skin damage & hyperpigmentation. I should avoid excessive sun exposure. It is STRONGLY advised that you use a broard spectrum protection product daily as part of your skincare routine.

    I acknowledge that this treatment is strictly elective cosmetic procedure and no medical claims have been expressed or implied. I understand that results may vary and cannot be guaranteed. 

    I acknowledge that I should avoid the use of Retin-A type products, aggressive exfoliation, waxing, and products containing acids that are not part of the recommended take-home regimen for 1 week following treatment.

    Consent

    I consent (to the best of my knowledge) that the answers I have given are correct and that I have not withheld any information that may be relevant to my treatment. I give consent for all future treatments

    I release Charlotte Rye of any liability associated with any injuries and /or current and future conditions resulting from the skincare procedures or products.

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