I understand that my data will be strictly confidential. This clinic does not sell, share, or resell information.
I understand, and have read and completed this intake truthfully. I agree that this constitutes full disclosure and that it supersedes any previous verbal or written disclosures. I understand that withholding information or providing misinformation may result in contraindications and/or irritation to the skin from treatments received. I know it is my responsibility to inform the esthetician/ skin care therapist of my current medical or health conditions and to update this history. The treatments I receive here are voluntary and I release this clinic and hold harmless against any claims, expenses, damages, and liabilities. I assume full responsibility thereof.