Jet Client Medical History, Consent and Aftercare Form

PLEASE READ CAREFULLY AND INITIAL / SIGN WHERE INDICATED.

Ensure all points below have been discussed with the technician. You are signing to state that you understand and accept these terms.

Jet Plasma uses a cooler atmospheric Jet and cold plasma that offers zero downtime as we are not creating surface area trauma. Since the skin channels are open when treating with Jet plasma it is important to refrain from wearing makeup, exercising, sauna, steam room for 12 hours from treatment time. Nothing should be put on the skin after treatment other than what your plasma practitioner puts on the skin. A series of treatments may be recommended for best results. (Initial Here)

I acknowledge that any information contributed by me is true, to the best of my knowledge and that the present condition of the area that has been treated or will be treated is stated on this record. I fully understand that there is no medical treatment involved. Jet Plasma Treatment is an art - not an exact science - and cannot guarantee an exact shrinkage result due to skin elasticity and individual healing process which includes client's health, genetics, lifestyle factors and following proper after care. (Initial Here)

I understand that I may be required to return for additional treatments before the overall procedure is deemed complete. The payment for any additional work, (if applicable), will be agreed prior to the treatment commencing. Depending upon area of treatment, additional treatments cannot be performed until after 48 hours.
(Initial Here)

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I understand that I may be required to return for additional treatments before the overall procedure is deemed complete The payment for any additional work if applicable will be agreed prior to the treatment commencing Depending upon area of treatment additional treatments cannot be performed until after 48 hours.
(Initial Here)

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I realize that with any beauty service there may be certain risks, which must be understood. I will be fully responsible for any and all results, which may arise from these beauty services.I , their affiliates and employees free from any and do hereby agree to hold all claims or suits for damage, for injuries or complications resulting from any beauty services provided by Iunderstand that the taking of before and after photographs of the said procedures is a condition of such procedure. I grant permission for the use of the photographs, or electronic media images as identified, in any presentation of all kinds. (Initial Here)

I have received post procedure instructions and will strictly adhere to them. I understand that my failure to do so may jeopardize my chances for a successful procedure outcome. (Initial Here)
(Initial Here)

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I realize that with any beauty service there may be certain risks, which must be understood. I will be fully responsible for any and all results, which may arise from these beauty services.I , their affiliates and employees free from any and do hereby agree to hold all claims or suits for damage, for injuries or complications resulting from any beauty services provided by Iunderstand that the taking of before and after photographs of the said procedures is a condition of such procedure. I grant permission for the use of the photographs, or electronic media images as identified, in any presentation of all kinds. (Initial Here)
(Initial Here)

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I understand the importance of my accurate and complete medical history. I understand that withholding any medical information may be detrimental to my health and safety during and after the procedure. I understand that if there is any change in my medical history it is my responsibility to inform the technician. (Initial Here)

I am aware that any skin altering procedures such as Laser treatments, plastic surgery, implants, injectables and weight gain or loss may alter the treatments look. (Initial Here)
(Initial Here)

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If the client is not completely satisfied with the end result of the treatments at 8-12 weeks, the client has to inform the service provider in private. This means that the client has to call, send a message or e-mail to the service provider. The service provider has to give a written response to the problem in no longer time than (7) seven business days. The service provider will provide the client with consultation, advice and in case a needed corrective procedure option that may cost additional fees. Neither of the parties is entitled to discuss criticism, complications, negative bad mouthing via social media or any sorts of issues relating to the procedure in public. In case such occurs, the party violating this clause shall be held legally liable and in breach of this contract and could be subject to legal charges from any negative slander and/or defamation of character that may harm the reputation of . By initialing, you agree to all terms and conditions set forth by and understand our non refundable policy due to the length of time taken and treatment/technique performed with the highest standard and most advanced, safe, Plasma technology.
(Initial Here)

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I, the client agree with all points listed and discussed,and wish to proceed as recorded with procedure with the Facialist. I participated fully in the decision for the selected area or areas intended for my Jet Pen Treatment I certify I have read and initialed the above paragraphs I have had it explained to my understanding therefore I consent to this procedure I accept full responsibility for the decision to receive this treatment
Client's Full Name

First NameLast Name
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I, Facialist Nameconfirm I have checked all paperwork including consent forms and medical history, I have discussed all procedure points with my client and they understand all elements of the Jet Pen Treatment. Aftercare advice has been verbally presented to the client and written instructions will be provided. fields and text.
I confirm I have checked all paperwork including consent forms and medical history, I have discussed all procedure points with my client and they understand all elements of the Jet Pen Treatment. Aftercare advice has been verbally presented to the client and written instructions will be provided.
Technician Signature

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JET PLASMA AFTERCARE INSTRUCTIONS

1. Following your treatment, due to the channels in the skin being open, it is important that nothing is applied to the skin for 12 hours other than what your skin care professional puts on your skin.

2. No makeup can be applied until 12 hours after the treatment.

3. No Exercise, Sauna, Steam room for 12 hours.

4. After 12 hours you can resume your normal skincare routine. Do not forget to apply your sunscreen everyday.
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Jet Client Medical History and Consent