Skin Deep Day Spa, LLC
1216 Wildwood, Suite C, Jackson, MI 49202
517.990.9088 - skindeepspajackson.com
Please complete this form thoroughly and answer the questions honestly.
Please Note: It is our policy that we do not offer any services to persons that are less than 12 weeks into their pregnancy. We request you set your appointment for a date after the initial 12 weeks of your pregnancy has passed.
WAXING - For us to provide any waxing service the hair must be 1/4 inch in length or longer.
TANNING - We request you referain from tanning for 48 hours or more before your service.
ANTI-AGING/ACNE LIGHT THERAPY - Our Celluma device offers zero physical contact by low level light therapy for anti-aging &/or acne. However, depending on where the light therapy is needed, for example over the face for anti-aging, acne or for pain management, one who suffers from claustrophobia may wish to see the device prior to scheduling a service. Also light therapy is not recommended for persons with epilepsy.
Post Facial Care/Waxing Instructions: Aerobic exercise and/or vigorous physical activity should be avoided for 24 hours. Direct sunlight exposure is to be avoided immediately following the treatment. A broad-spectrum sunscreen of SPF 30 should become part of your daily skin care regimen. Your skin can become more sensitive to sun in a result of this treatment. Unless otherwise specified, in the evening following your treatment, cleanse your skin with a mild cleanser and water followed by a non-active moisturizer. Do not apply additional exfoliating ingredients/products the day of your service as over-exfoliation can result in irritation or further sensitivity. Consult your Esthetician before resuming topical treatments. Facial treatments and waxing can result in skin flushing/redness or slight skin flaking or sensitivity for up to 48-72 hours post treatment. DO NOT peel, pick, rub, or scratch your skin at any time, whatsoever. This can potentially cause damage or compromise your results.
In signing this form I acknowledge and testify as to the following;
All information I have given both written &/or verbally, is true to the best of my knowledge and it is my sole responsibility to inform &/or update Skin Deep Day Spa LLC as to any changes in my health status &/or personal information.
I, the client, as well as the attending practitioner have the right to stop or refuse any treatment or service at any time.
I understand, Skin Deep Day Spa LLC’s practitioners do not diagnose any illness or medical condition, nor will Skin Deep Day Spa LLC’s practitioners work outside guidelines as defined by the State of Michigan in Scope of Practice for the type of service offered at any time for any reason.
I hereby release, hold harmless, waive, discharge, and covenant not to sue Skin Deep Day Spa, LLC, its directors, oﬃcers, employees, volunteers, and agents with respect to any liability for any injury, loss, and/or damage (including, but not limited to, illness or death) that I may sustain related to services &/or treatments rendered. I further hereby knowingly consent to receive treatment from Skin Deep Day Spa, LLC.