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  •  Note: Unfortunately, any active sores on the facial area will result in no treatment to decrease the risk of spreading the sore to multiple areas. Let's reschedule!

  • I understand, have read and completed this questionnaire truthfully. I agree that this constitutes full disclosure, and that it supersedes any previous verbal or written disclosures. I understand that withholding information or providing misinformation may result in contraindications and/or irritation to the skin from treatments received. The treatments I receive here are voluntary and I release this institution and/or skin care professional from liability and assume full responsibility thereof.

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