-I understand that a “superficial chemical peel” may be useful in improving the appearance of the skin, may reduce the appearance of fine lines and wrinkles and diminish pigmentary irregularities.
-I am undergoing this peel in an effort to improve my skin texture and color. I understand that the results of this treatment vary according to age, condition of skin, sun damage, smoking and climate. I may achieve improvements as well, but no guarantee has been made to me regarding my level of improvement from this peel.
-I have received information as to how to care for my skin prior to and following this procedure and agree to abide by them. I understand that proper sun protection including, but not limited to, the faithful use of broad spectrum UVA-UVB sun block with a minimum of SPF 45 is vital to proper after care and the reduction of risks of undesired side effects.
-I understand that there is a small risk of developing: temporary or permanent pigment (color) change in the skin, reactivation of “cold sores” (herpes infections) in patients with a prior history of herpes, flare of acne-like lesions and slight possibility of scarring and/or infection. I understand I should not “pick” at any scabbing that may result, to minimize the potential of scarring or infection.
-I understand that there is a possibility that this procedure may be unsuccessful and generally require additional treatments to achieve optimal results.
-Chemical peels may cause, at most, 1 to 7 days of mild redness with areas of flaking or peeling skin. On rare occasions this peel can penetrate deeper in certain areas.
-I am NOT: allergic to salicylates (i.e. aspirin), Pregnant or lactating.
-I agree to having photographs taken of my skin for use either in teaching or to evaluate treatment effective- ness. NO photographs revealing my identity will be used without my written consent. If my identity is not revealed, these photographs may be used and displayed publicly without my permission.
- I am aware this service is 2 seperate appointments. On your first appointment you will recieve a consultation and our exclusive Lightening Kit and exfoliating gloves valued at $185. You will then come back in for your second appointment within one months time to recieve your Glam V Peel Valued at $125. Payment must be made after your first appontment in full. If for any reason, you choose to cancel your glam V peel session amd request a refund, you will still be responsible for the 2 month supply Lightening Kit.
- NO SHOWS ON BOOKED PAID IN FULL APPOINTMENT WILL RESULT IN A $25 FEE TO REBOOK
-By my signature below, I acknowledge that I read “Glam Body Sugaring Boutique Glam V Peel Consent Form” and understand it. I have been given the opportunity to ask questions and my questions have been answered to my satisfaction. I have been adequately informed of the risks, benefits and alternatives to this treatment and wish to proceed with the Chemical Peel.