Dermaplaning Consent Form

I, (first name, last name)* , give my consent to the following procedure: dermaplaning to be performed by Rawe Beauti Skin + Body Bar.

I understand dermaplaning is a physical/mechanical form of exfoliation which removes dead skin cells and vellus hair (peach fuzz) using a surgical scalpel. As with the use of any sharp instrument, there is the possibility of nicks or cuts.

I understand there are contraindications to this treatment, including but not limited to, diabetes (not controlled by diet or medication), cancer, active acne, bleeding disorders, the inability for blood to coagulate or the development of keloids following injury. Certain medications including blood thinners, higher dosages of Aspirin, and Accutane are contraindicated for this treatment due to the possibility of delayed clotting from a nick or cut.
I certify that I am not taking any of the above medications or experiencing any of the above conditions.
While every precaution will be taken to avoid nicks, cuts and scratches, I understand the risks and consent to treatment today.

Name*

First NameLast Name

Email*

example@example.com

Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

How did you hear about us?

Today's Date*

Date

Signature*

By clicking/tapping/touching/selecting or otherwise interacting with the "Submit" button below, you are consenting to signing this Document electronically. You agree your electronic signature ("E-Signature") is the legal equivalent of your manual signature on this Document. You consent to be legally bound by this Document's agreement(s), acknowledgement(s), policy(ies), disclosure(s), consent term(s) and condition(s). You agree that no certification authority or other third party verification is necessary to validate your E-Signature and that the lack of such certification or third party verification will not in any way affect the enforceability of your E-Signature. You may request a paper version of an electronic record by writing to us. We reserve the right to charge a reasonable fee for the production and mailing of a paper version of the record. Your current valid email is required for all communications.