I certify that I have read, and fully understand that the above paragraphs and that I have had sufficient opportunity for discussion to have any questions answered. I understand the procedure and accept the risks and agree to keep my eyes closed at all times unless ortherwise unstructed to do so. I have accurately answered the questions above, including listing all known maladies, allergies, prescription drugs or products I am currently ingesting or using topically. I understand that my technician will take every precaution to minimize or eliminate negative reactions as much as possible. In the event that I may have additional questions or concerns regarding my treatment. I will consult the technician immediately. I agree that this constitutes full disclosure and that it supersedes any previous verbal or written disclosures.
I give permission to the technician to perform the servic(s) we have discussed and I wil hold them, the salon and its staff harmless from liability that may result from the service(s). I will not hold the technician responsible for any of my conditions that were present but not disclosed at the time of this procedure, which may be affected by the treatment performed today.