1. Acknowledgment of Risk and Consent to Treatment
I, the undersigned, voluntarily consent to receive skincare services from Embrace Skin Studio, LLC. I understand that these services may include, but are not limited to, facials, extractions, exfoliation, microdermabrasion, LED therapy, high frequency, and dermaplaning. I acknowledge that while these treatments are intended to improve the appearance and health of my skin, results may vary, and specific outcomes are not guaranteed.
I understand that there are inherent risks associated with skincare treatments, including but not limited to redness, irritation, allergic reactions, hyperpigmentation, scarring, and worsening of skin conditions. I acknowledge that I have been informed of these potential risks and agree to proceed with the treatments at my own risk.
2. Disclosure of Medical Conditions and Medications
I have provided accurate and complete information regarding my medical history, current health conditions, and any medications or topical treatments I am using. I understand that failure to disclose such information may result in adverse effects, and I agree to hold Embrace Skin Studio, LLC harmless for any issues arising from incomplete or inaccurate disclosure.
3. Contraindications and Postponement of Services
I acknowledge that certain medical conditions and recent cosmetic procedures may contraindicate the provision of skincare services. These include, but are not limited to, active cold sores, Accutane use within the past 6 months, prescription retinoids within one week of treatment, recent Botox or filler injections, and other health conditions as determined by the esthetician. I understand that Embrace Skin Studio, LLC reserves the right to postpone or modify the treatment plan to ensure my safety and the appropriateness of the service.
4. Release of Liability
I hereby release and hold harmless Embrace Skin Studio LLC, including its employees, its agents, and affiliates, from any and all claims, demands, damages, actions, or causes of action arising from or related to the services provided. This release of liability applies to both known and unknown claims, and I expressly waive the provisions of Section 1542 of the California Civil Code, which states: “A general release does not extend to claims that the creditor or releasing party does not know or suspect to exist in his or her favor at the time of executing the release, which, if known by him or her, would have materially affected his or her settlement with the debtor or released party.”
5. Dispute Resolution and Arbitration
In the event of any dispute, claim, or controversy arising out of or related to the services provided or this agreement, the parties agree to first attempt to resolve the matter through good-faith negotiation. If the dispute cannot be resolved through negotiation, the matter shall be submitted to binding arbitration in accordance with the rules of the American Arbitration Association (AAA). The arbitration will be conducted in San Francisco, California, and the decision of the arbitrator shall be final and binding on all parties. Each party shall bear its own costs and expenses of the arbitration, including attorney’s fees.
6. Consent to Treatment and Signature
By signing below, I acknowledge that I have read and fully understand the terms of this Liability Waiver and Consent Form. I agree to the terms and conditions set forth herein, and I consent to receive skincare services from Embrace Skin Studio LLC. I understand that I may request a copy of this form for my records.