My signature below indicates that I have agreed to receive the GetGlowing Micro-Peel treatment(s). I agree to the following:

• I am not pregnant, breast feeding or trying to conceive. 
• I am not allergic to Salicylates (aspirin), Kojik acid or Resorcinol.
• I am currently not taking or using any medications that are contraindicated to receiving a chemical peel i.e., Accutane or light sensitizing antibiotics or other light sensitizing medications. 
• I do not suffer from cold sores/fever blisters or have a history thereof and if I do, I am taking an antiviral medication.
• I have not had prolonged sun exposure for at least 2 weeks prior to the GetGlowing Micro-Peel, nor will I expose my skin to the sun for a minimum of one to two months post my final peeling treatment. I am not using a sun bed. 
• I will apply daily, a broad-spectrum sun protection product, of at least SPF30 and will re-apply frequently. 
• I am not a cancer patient taking oral chemotherapy, undergoing chemotherapy or radiation and I do not have an autoimmune disease.
• I understand that sweat and heat must be avoided for a minimum of 7 days post my peeling application. Sweat may cause a heat rash resulting in blisters, painful stinging/burning inflamed skin, swelling, oozing lumps, extreme itch, and acne breakouts, which will retard recovery.

Informed Consent

The GetGlowing chemical peel treatment has been fully explained to me and any questions or concerns have been addressed. I acknowledge that no specific results or percentage of improvement following treatments, are guaranteed, and that the treatments need to be repeated several times (a series of 6 peels is recommended). This treatment is voluntary on my part. The GetGlowing Micro-Peel is an acidic cream applied to the skin to lightly exfoliate the skin’s damaged outer layers. New cells and collagen are stimulated during the healing process, to produce a smoother, tighter, younger-looking skin surface. Results will vary depending on the condition and general health of the skin.  The peel does not eliminate sagging or excess skin. Because these peels are a light exfoliation of the skin, you may or may not experience visibly peeling or flaking. I understand that following the treatment, my skin may appear red, feel tight and sting or burn.

Possible side effects include and are not limited to slight or extreme redness, swelling, stinging, burning, itching, tenderness, possible allergic reaction and dry or flaking skin. I understand that I am not to pick or scratch the flaking skin as this will lead to the formation of unwanted pigmentation and possible infection. Most side effects will gradually diminish over time. Healing may take several days.

BY SIGNING BELOW, I ACKNOWLEDGE THAT I HAVE READ THE ABOVE INFORMATION AND THEREBY CONSENT AND AGREE TO THE TREATMENT WITH ITS ASSOCIATED RISK. I HEREBY CONSENT TO RECEIVE A GET GLOWING MICRO-PEEL.