Acknowledgement and Waiver
I understand that it is unlawful to receive treatment while having a contagious illness. I understand I can not be serviced while having a contagious illness, and therefore will have to forfeit my appointment and pay the cost due.
I UNDERSTAND THAT IF I WILLINGLY ARRIVE AT MY APPOINTMENT WITH A CONTAGIOUS CONDITION, OR HAVE RECIEVED ANY MEDICAL PROCEDURE IN THE PAST MONTH, OR RECIEVED INJECTIONS, BOTOX, MICRONEEDLING OR ANY INVASIVE TREATMENT IN THE PAST 2 WEEKS, I WILL FORFEIT MY APPOINTMENT AND PAY ALL COST DUE.
I agree to immediately inform the esthetician if I experience any pain or discomfort during the session so that the products and/or technique may be adjusted to my level of comfort. I further understand that this service should not be construed as a substitute for medical examination, diagnosis, or treatment. I understand that estheticians are not qualified to perform, diagnose, prescribe, or treat any physical or mental illness, and that nothing said in the course of the session given should be construed as such.
I agree to keep the esthetician updated as to any changes in my medical profile during the session and understand that there shall be no liability on the estheticians part should I fail to do so. I understand that any illicit or sexually suggestive remarks or advances made by me will result in immediate termination of the session and legal action.
I understand that any information provided by the therapist is for educational purposes only and not diagnostically prescriptive.
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.