• Bareskin Beauty

    Chemical Peel Consent Form
  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Listed below are contraindications for any chemical peel service. Please check all that apply to you. If none apply leave boxes unchecked.
  • Recommended aftercare instructions:

    Avoid sweating, exercising, hot baths/showers, scrubbing, retinoids, or AHAs/BHAs, picking/rubbing, and sun exposure. Please wear protective sunscreen and/or clothing for at least 2 weeks after treatment. Failure to do so may result in adverse effects. By signing this form you are consenting that you will follow these instructions and assume all risks that may or may not occur after chemical peel treatment is completed.

  • I agree that the above information is accurate to the best of my ability, I also agree to use all recommended aftercare instrauctions listed above or spoken at time of appointment while the skin is healing. If I have any questions or concerns i will contact Bareskin Beauty LLC immediatily as these occur. Chemical peels are not recommended for persons under 18 years old unless the esthetician approves with parental consent.

  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Should be Empty: