INFORMATION AND CONSENT - MICROCURRENT FACIAL

INFORMATION AND CONSENT - MICROCURRENT FACIAL
PLEASE BE AWARE OF THE FOLLOWING INFORMATION AND POSSIBLE RISKS AND INITIAL TO ACKNOWLEDGE:
I understand there are certain contraindications that would preclude me from receiving microcurrent treatments, including autoimmune disorders, diabetes, embolism, epilepsy, melanoma, metal implants including plates/pins/screws, open wounds, pacemaker use, phlebitis, pregnancy, thrombosis, and varicose veins. *
Please Initial
I understand that the use of Botox®, Juvederm®, Restylane®, and any other injectable must be disclosed prior to treatment. *
Please Initial
I understand that microcurrent treatments involve conducting mild electrical currents through the body, and that this brings some inherent risk. *
Please Initial
I understand that reactions are rare, but may include nausea, dizziness, weakness, and possible skin reactions including redness and/or other irritations. *
Please Initial
I understand that some clients report slight tingling sensations, flashing of the optic nerve, and/or a metallic taste in the mouth during the procedure. *
Please Initial
I understand that while the goal of this treatment is to improve the vitality of the skin, no specific guarantees of the result can or have been made. *
Please Initial
I understand that it is imperative to my health that I disclose all of the information requested in the Client Profile/Health History. *
Please Initial
I have cited all conditions and circumstances regarding my health history, medications being taken, and any past reactions to products or medications. *
Please Initial
I understand that additional conditions could occur or be discovered during the procedure which could affect my ability to tolerate the procedure. *
Please Initial
Photographs: I give permission for photographs to be used by Viso Bello Spa for educational plus promotional purposes. Complete Patient confidentiality will be maintained at all times. *
Please Initial
CLIENT NAME (PRINTED) *
CLIENT NAME (SIGNATURE) *

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Date *

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Please read, sign, and return:

CANCELLATION POLICY

Your spa treatments are reserved especially for you We value your business and ask that you respect the spa's scheduling policies. Should you need to cancel or reschedule, Please notify us at least 24 hours in advance. Any cancellations with less than 24 hours notice are subject to a cancellation fee amounting to 50% of the cost of the scheduled service.

Clients who miss their appointments or arrive 15 minutes or more late to their appointment without giving any prior notice will be charged in full to the credit card on file for the scheduled service. We recognize the time of our clients and staff is valuable and have implemented this policy for this reason. When you schedule your appointment with us you are agreeing to these policies.

SPA ETIQUETTE

We strive to maintain a relaxing and professional atmosphere at all times. With this goal in mind please review the following:

Children: To ensure the safety of your children, and the serene environment for our clients, please make other arrangements for your children during your appointment. Children are not permitted in the lobby or treatment areas unless they are receiving a service. If you arrive to your appointment with children, you will be asked to reschedule and you will be charged for a missed appointment.

Cell Phones/ Devices: Please turn off your cell phone upon entering the lobby so as not to disturb other guests. If you must take a call, please do so outside.

Pets: No pets are allowed in our lobby or treatment rooms unless they are designated service animals.

Inappropriate Behavior: We reserve the right to refuse or terminate any appointment for inappropriate behavior. If an appointment is terminated due to lewd or otherwise offensive behavior, the full amount of the scheduled service will be charged. If an appointment is terminated for these reasons we reserve the right to refuse
future appointments as well.

RETURN POLICY:

Refunds or exchanges ,may be given on unopened & unused product within 10 days of purchase. Opened skin care products will not be accepted for return or exchange. ALL SALES ARE FINAL on any services, treatments, pre pays, & gift cards.
Please sign to acknowledge receipt of our policies: *

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INFORMATION AND CONSENT - MICROCURRENT FACIAL

PLEASE BE AWARE OF THE FOLLOWING INFORMATION AND POSSIBLE RISKS AND INITIAL TO ACKNOWLEDGE: