1942 Sam Rittenburg Blvd Suite D
Charleston, SC 29407
Skincare Consent with COVID Consent Form
I understand treatments can include microdermabrasion, chemical exfoliants, use of
energy treatments such as micro-current and LED, and radio frequency. This is not a medical procedure and elective with no guarantee of results. I understand there could be redness, dryness, peeling of my skin, and there is a risk for hyper pigmentation (dark areas) during the treatment process that may remain. I agree to notify the office immediately with concerns. I understand I may be asked to return to the office for additional treatment. I give my consent for photographs to be taken. I understand unidentifiable portions of these photos may be published.
I understand that skincare treatments involve maintained touch and close physical
proximity over an extended period of time, there may be an elevated risk of disease
transmission, including COVID-19 even with enhanced sanitation methods in place.
By signing this form, I acknowledge that I am aware of the risks involved and give
consent to receive treatments from therapists and employees at SkinPro Studio. My
consent is ongoing for as long as I seek services unless I withdraw this consent in
writing. I authorize treatment until I notify SkinPro Studio in writing to revoke this
IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the
day and year first above written.