I acknowledge that:

• I must disclose of any condition that may be a contraindication to the procedure, such as pregnancy, allergies, facial peels/surgeries/waxing, use of glycolic or Retin-A type products, tendencies to cold sores or fever blisters, prior to receiving treatment.
• I understand that no specific results are guaranteed. or the percentage of improvement expected following treatment.
• I will follow the home care program specifically designed for me without changing or adding any products without consulting with my skin care professional.

• I have completed this form to the best of my knowledge and agree to inform the esthetician of any changes with the above information. I have been informed of and understand the contraindications to the requested treatments and agree that I do not have any condition(s) that would make the requested treatment unsuitable. I agree to waive all liabilities toward my esthetician for any injury or damages incurred due to any misrepresentation of my health history.