Consent for Service & Agreement to Pay

Prior to receiving treatment, I have been candid in revealing any condition that may

have bearing on this procedure, such as: pregnancy (if so, consult your physician

prior to treatment), recent facial surgery, allergies, tendency to cold sores/fever

blisters, or use of topical and/or oral retinoid treatments such as: tretinoin, Retin-A®, isotretinoin, Accutane®, Differin®, Tazorac®, Avage®, EpiDuo®, or Ziana®.

I understand there may be some degree of discomfort, such as stinging, pin-prickling

sensation, heat, or tightness.

I understand there are no guarantees as to the results of this treatment, due to many

variables, such as: age, condition of skin, sun damage, smoking, climate, etc.

I understand I may or may not actually peel and that each case is individual.

I understand that the amount of peeling does not correlate with degree of

improvement.

I understand this treatment is a cosmetic treatment and that no medical claims

are expressed or implied.

I understand that to achieve maximum results, I may need several treatments.

I understand that although complications are very rare, sometimes they may occur

and that prompt treatment is necessary. In the event of any complications, I will

immediately contact the physician/clinician who performed the treatment.

I agree to refrain from tanning in tanning beds or outdoors while I am undergoing

treatment, and during the 14 days prior to and following the end of treatment. This

practice should be discontinued due to the increased risk of skin cancer and signs

of aging.

I understand that extended direct sun exposure is prohibited while I am undergoing

treatment, and the daily use of sunscreen protection with a minimum SPF of 30

is mandatory.

I have not had any other chemical peel of any kind within 14 days of this treatment.

I understand I cannot have another chemical peel within 14 days of this treatment,

whether it is performed at this location or any other location.

I understand that I should follow my clinician’s recommendations for post-procedure

skincare to minimize side effects and maximize results.

I hereby agree to all of the above and agree to have this treatment performed on me.

I further agree to follow all post-peel care instructions as I am directed.

Payment is due immediately after service is redered.
The Seller agrees to provide the Services in a professional and timely manner, as per the agreed-upon scheduled service.

Legal Binding Signature. The Client acknowledges that the signing of this Agreement constitutes a legally binding commitment to pay for the Services as outlined in this Agreement. The Client understands that by signing this document, they are agreeing to all terms and conditions set forth herein.

This Agreement constitutes the entire understanding between the parties and supersedes all prior or contemporaneous discussions, agreements, and understandings, whether written or oral, regarding the subject matter hereof.

Seller:
Renew Skin n' Body, 7965 W. Sahara Ave, Las Vegas NV, 89117

Acknowledgement:

The Client acknowledges that they have read and understood the terms and conditions of this Agreement, and by signing below, agrees to be bound by the terms and conditions as set forth above.