I authorize Pure Esthetics to perform Liquid Microneedling (CELLSTORY) treatments for me.

I understand that Liquid Microneedling (CELLSTORY) is a patented eight-step skincare program that utilizes innovative Microspears®, which are particles derived from fresh water grown sponges. CELLSTORY is commonly referred to as "liquid microneedling". CELLSTORY helps to minimize the appearance of fine lines and wrinkles, improve skin texture and deliver bouncy, healthy, and glowing skin. The system features a 20 amino acid complex to provide moisture and nourishment, and is made without harmful preservatives, artificial colors, or artificial fragrance. CELLSTORY takes approximately 1 hour with no numbing, needles or downtime.

I understand that I might experience the following side effects and will confirm that it is normal:

• Skin redness and dryness may occur
• While rare, mild swelling may also occur
• Skin tingling for up to 72 hours

I confirm that I will follow these post-care instructions:

• Lightly cleanse the face with a gentle cleanser that evening or the next morning
• Apply moisturizer to the skin frequently
• For best results, we recommend using Beyond Miracles Miracletox Mini Set for at least 72 hours following your facial
• Use sunscreen daily
• Avoid any retinols or exfoliants (physical or chemical) for 72 hours
• Avoid any face oils or oil-based products for 72 hours
• Avoid heavy sweating (i.e., saunas, heavy exercise) for 72 hours
• Avoid sun exposure for 72 hours
• Avoid chemical peelings or lasers for 1 week

I understand that this procedure does not guarantee any specific result.

I understand the risks and complications of this procedure and I still like to proceed with it. These are the following risks: infection, hyperpigmentation, allergic reaction, scarring, pain, itchiness, or swelling.

I understand that this procedure or service is non-refundable.

I release Pure Esthetics from any liabilities and hold harmless against damages or accidents that might happen during the procedure.

I confirm that I had the chance to ask any questions about the treatment and I receive satisfactory replies.

I confirm that I will consult my physician if I have the following contraindications:

• Currently pregnant or lactating (we advise that you speak with your medical provider before using any of our products
• Current open wounds on the skin
• Strong nut allergy (a small percentage of Macadamia Oil is present in the CELLSTORY PLUS Recovery Cream)
• Received Botox or fillers in the past 14 days
• Received lasers, chemical peels, micro needling or mesotherapy in the past 7 days