By signing this document I hereby consent to the following:

I understand that my data will be strictly confidential. This clinic does not sell, share, or resell information.  I confirm that all information in this form is true and accurate. I confirm that if I hold back some important information and complications happen, the clinic will not be liable. I release this clinic and hold harmless against any claims, expenses, damages, and liabilities.

If I experience any pain or discomfort during the session, I will immediately inform the esthetician so that the products and/or technique may be adjusted to my level of comfort.

I further understand that facials or any other services rendered 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 esthetician's 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.

Also, I understand that the services offered are not a substitute for medical care, and any information provided by the therapist is for educational purposes only and not diagnostically prescriptive in future.