I have read the above information. If I have any concerns, I will address these with my service provider. I give permission to Niamh to perform the services outlined above and will hold her harmless from any liability that may result from this treatment. I have accurately answered the questions above, including all known allergies, prescription drugs, or products I am currently ingesting or using topically. I understand that Niamh will take every precaution to minimize or eliminate negative reactions as much as possible. In the event I may have additional questions or concerns regarding my treatment, I will consult my service provider immediately. I agree that this constitutes full disclosure and that it supersedes any previous verbal or written disclosures. I certify that I have read, and fully understand the above paragraphs and that I have had sufficient opportunity for discussion to have any questions answered. I understand the procedure and accept the risks. I do not hold the Niamh of Beausheful by Niamh Kennedy, my service provider, responsible for any of my conditions that were present, but not disclosed, at the time of this service, which may be affected by the treatment performed today.