Post Facial Care/Waxing Instructions: Aerobic exercise and/or vigorous physical activity should be avoided for 48 hours. Direct sunlight exposure is to be avoided immediately following the treatment (including any strong UV light exposure and/or tanning beds). If some sun exposure cannot be avoided first apply a broad spectrum sunscreen of SPF 30. Sunscreen (with a minimum SPF 15) should become part of your daily skin care regimen as skin can potentially become more sensitize to the sun as a result of this treatment. Unless otherwise specified, in the evening following your treatment, cleanse your skin with a mild cleanser and water followed by a non-active moisturizer. Do not apply additional exfoliating ingredients/products the day of your service as over-exfoliation can result in irritation or further sensitivity. Consult your skin care professional before resuming topical treatments. Enzyme peels, DermaFile or DermaDisc treatments, chemical peels or facial waxing can result in skin flushing/redness or slight skin flaking or sensitivity for up to 48-72 hours post treatment. DO NOT peel, pick, rub, or scratch your skin at any time, whatsoever. This can potentially cause damage or compromise your results.*
1, the undersigned ("Customer"), consent to have my natural eyelashes lifted/permed and tinted (the "Service") by LIZ RATHE / LAVENDER SKYE ESTHETICS and his/her/its staff assistants, contractors, employees or students (collectively herein, the "Service Provider"). The Service and its associated risks have been explained to me by the Service Provider in terms that I understand. The explanation included:
• The benefits of the Service; • The nature of the Service and how the Service will be performed; . The types of materials and products used during the Service; • The most frequently occurring risks of the Service, and those risks which are unlikely to occur but which may
involve serious consequences, including but not limited to the risk of experiencing:(a)Blepharitis and its associated symptoms, (b)an allergic reactions to the perming cream used to perm my natural eyelashes, (c)Traction Alopecia and its associated symptoms; (d) an eye injury due to perming cream falling on or into the
eye; and (e)an eye or other injury occurring during the performance of the Service; • How to properly care for my lashes after permed; and how often I should expect to need to repeat the Service. I was given the opportunity to ask the Service Provider any questions I have regarding the Service and I have had those questions answered to my satisfaction. Based on the foregoing, I hereby assume all of the risks associated with the Service, whether known or unknown, including, but not limited to, the risk of personal injury or property damage. As consideration for Service Provider performing the Service, I forever release Service Provider and his/her/its respective directors, officers, members, managers, employees, agents, contractors, attorneys, representatives, successors and assigns from any and all actions, claims, or demands that I, my assignees, heirs, next of kin, spouse, personal representatives and legal representatives now have, or may have in the future, for injury, death, or property damage, in any way related to the Service. By signing at the end of this paragraph, I grant the Service Provider permission to reproduce, publish, distribute or otherwise use in any reasonable manner my name, photograph, likeness and statements, including, but not limited to, before and after pictures of my eyes and eyelashes in connection with the promotion of the Service or the products used in the Service (or other similar services and products) in all media, including without limitation, the internet, news articles, advertisements, or other electronic or printed materials. If my signature is not present at the end of this form, then the above described permission has not been granted.
I have voluntarily elected to undergo this treatment/procedure after the nature and purpose of this treatment has been explained to me, along with the risks and hazards involved, by Elizabeth Rathe (esthetician). Although it is impossible to list every potential risk and complication, I have been informed of possible benefits, risks, and complications. I also recognize there are no guaranteed results, and that independent results are dependent upon age, skin condition, and lifestyle, and that there is the possibility I may require further treatments of the treated areas to obtain the expected results at an additional cost. I have read and understand the post-treatment home care instructions. I understand how important it is to follow all instructions given to me for post-treatment care. In the event that I may have additional questions or concerns regarding my treatment or suggested home product/post-treatment care, I will consult the esthetician immediately. I have also, to the best of my knowledge, given an accurate account of my medical history, including all known allergies or prescription drugs or products I am currently ingesting or using topically. I have read and fully understand this agreement and all information detailed above. I understand the procedure and accept the risks. All of my questions have been answered to my satisfaction, and I consent to the terms of this agreement. I do not hold the esthetician, Elizabeth Rathe, responsible for any of my conditions that were present but not disclosed at the time of this skincare procedure, or that may occur and which may be affected by the treatment performed today. My questions regarding the treatment have been answered satisfactorily. I understand the treatment and accept any risks. I hereby release (individual) and (facility) from all liabilities associated with the above-indicated treatment. I agree that this consent supersedes any previous verbal or written disclosures. This consent is valid for all of my facial treatments in the future as well. Waiver, Release, and Assumption of Risk: I understand that as a result of my participation in this session, I could suffer an injury and hereby agree that I am doing so at my own risk. In any event, I acknowledge and agree that I assume the risks associated with any and all activities in which I participate. I acknowledge and agree that no warranties or representations have been made to me regarding the results I will achieve from this session. I understand that results are individual and may vary. I do here and forever release and discharge and hereby hold Elizabeth Rathe/Lavender Skye Esthetics harmless from any and all claims, demands, rights of action, or causes of action, present, or future, arising out of or connected with my participation in this or any session, including any injuries resulting therefrom. THIS WAIVER AND RELEASE OF LIABILITY INCLUDES, WITHOUT LIMITATION, INJURIES WHICH MAY OCCUR AS A RESULT OF 1) EQUIPMENT THAT MAY MALFUNCTION OR BREAK; 2) ANY SLIP, FALL, DROPPING OF EQUIPMENT OR PROPERTY WITHIN PREMISES; AND 3) AILMENTS DURING/POST-INSTRUCTION. I ACKNOWLEDGE THAT I HAVE THOROUGHLY READ THIS WAIVER AND RELEASE AND FULLY UNDERSTAND THAT IT IS A RELEASE OF LIABILITY. BY SIGNING THIS DOCUMENT, I AM WAIVING ANY RIGHT I OR MY SUCCESSORS MIGHT HAVE TO BRING A LEGAL ACTION OR ASSERT A CLAIM AGAINST ELIZABETH RATHE or LAVENDER SKYE ESTHETICS, INCLUDING ANY FUTURE LEGAL ACTIONS OR CLAIMS.*