GlassGlow Informed Consent
GLASSGLOW
Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Client Name
First Name
Last Name
I understand that Dermaplaning involves the use of a sterilized surgical blade to remove fine vellus hair from the face, and provide light exfoliation
*
Please Select
Yes
No
I understand that the treatment may involve the risk of complication or injury and I freely assume those risks. Possible side effects of the treatment area can include mild redness, mild irritation, and dryness. Additionally, nicks to the skin can occur due to the sharp surgical blade. The hair that grows back will not be darker or thicker, however I do understand that any hormone imbalance present within my anatomical system can alter the normal hair growth pattern.
*
Please Select
Yes
No
If a chemical peel is included with this treatment, I understand that the sensation and penetration of the peel will be enhanced. This may cause skin irritation, mild discomfort, tenderness, lightening or darkening of the skin, infection, scarring, peeling, and activation of cold sores, when virus is ALREADY present in the body. I certify that I have read this entire consent form and I understand and agree to the information provided in this form. I certify that I am at least 18 years of age, or I have a parental consent co-signed below. I will call to inform my aesthetician of any complications or concerns as soon as they occur. I certify that I have read the above consent and I fully understand it and give my consent to the Glassglow Dermaplaning treatment.
*
Please Select
Yes
No
Signature
*
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
GLAROINE
Submit
Should be Empty: