I hear by consent to and authorized Beauty Room by Rae to perform the above stated services.
I have voluntarily chosen to undergo this treatment/procedure after the nature and purpose of this treatment has been explained to me along with benefits, risks, and hazards involved.
Although it is impossible to list every potential risk and complication, I have been informed of possible benefits, risks, and and complications. I also recognize that there are no guaranteed results and that independent results are dependent upon age, skin condition, and lifestyle. I understand that there is a possibility that I may require additional treatments of the treated area to obtain the expected results at an additional cost.
I have read and understand the pre-and post treatment, homecare 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 homecare products, post treatment care I will consult the aesthetician 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 using topically or ingesting.
By signing below I agreed to the following:
I have completed this form to the best of my ability and knowledge. I agreed to inform the aesthetician of any changes in the above information. I agree that I do not have any conditions that would make the requested treatment unsuitable. I will inform the aesthetician of any discomfort. I may experience at any time during my treatment to allow them to adjust accordingly. I agree to waive all liability or responsibility towards the aesthetician and Beauty Room by Rae, for any injury or damages incurred due to any misinterpretation of my health.
This agreement will remain in effect for the procedure and all future treatments, services, and follow-ups conducted by the aesthetician. I understand that this consent agreement is legal and binding. I have read and fully understand all information in this agreement. I am over 18 years of age and I consent to the agreement and to the procedure. In the event of the client being under 18 years of age I have had a parent or legal guardian consent to this agreement.