By signing below. I agree to the following:

I have completed this form to the best of my knowledge and ability. I agree to inform the esthetician of any changes in the above information.
I agree that I do not have any condition(s) that would make the requested treatment unsuitable. I will inform the esthetician of any discomfort I may experience at any time during my treatment to allow them to adjust accordingly. I agree to waive all liability toward my esthetician and the salon suite for any injury or damages incurred due to any misrepresentation of my health.

I hereby consent to and authorize Ashlee Roberts at Opal Skin Aesthetics LLC to perform the following procedure: Facial and/or body treatment

I have voluntarily elected to undergo this treatment/procedure. The nature and purpose of this treatment has been explained to me prior to signing.

I understand and acknowledge that there are risks involved with the treatment I will be receiving. Although it is impossible to list every potential risk and complication I have been informed of possible benefits, risks, and complications. I have had the opportunity to ask questions regarding these risks and other possible complications before my service.

I understand there are no guaranteed results and that independent results are dependent upon age, skin condition and lifestyle. I also recognize that there is a possibility I may require further treatments of the treated areas to obtain the expected results at an additional cost.

I have read and understand the post-treatment home care instructions. I understand how important it is to follow all instructions given to me for post-treatment care. In the event that I may have additional questions or concerns regarding my treatment or suggested home product/post-treatment care, I will consult the esthetician immediately.

I have, to the best of my knowledge, given an accurate account of my medical history, including all known allergies or prescription drugs and products am currently ingesting or using topically.

I have read and fully understand this agreement and all information detailed above. I understand the procedure and accept the risks. I agree to assume the risk and full responsibility for any and all injuries, losses, side effects, or damages that might occur to me while I am undergoing this procedure. I do not hold the esthetician, whose signature appears below, responsible for any of my conditions that were present, but not disclosed at the time of this skincare procedure, which may be affected by the treatment performed today.