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Zena Algae Peel Consent Form

  • I understand that I may experience skin sensitivity and/or thinning that may result in skin peeling and dryness. I verify that I have informed my aesthetician of all previous and current products used, past procedures, and other treatments received.

  • I understand that reactions may occur even if no reactions occurred during or after previous treatments.

  • I have been informed that several appointments may be required to achieve and maintain my desired results. I understand that results may vary and that satisfaction is

  • I understand that failing to commit to the recommended skincare regimen can make a noticeable difference in the treatment outcome.

  • I verify that I have received sufficient opportunity for discussion to address any concerns and have questions answered.

  • I understand that physical or chemical exfoliating services will result in vulnerable skin due to the removal of superficial layers of the skin.

  • I understand that infection is rare, but may occur and is serious.

  • I have been informed that it is normal to experience discomfort, skin irritation, redness. sensitivity, and dryness immediately after treatment and freely accept those risks.

  • I understand that I may have an allergic reaction to products, tools, or materials used. I have been offered a patch test and understand that even if a patch test is performed, it does not guarantee against an allergic reaction. If the patch test is waived, I release my aesthetician from liability if I develop an allergic reaction.

Patch Test:
Waive Patch Test
Take Patch Test
  • I understand the procedure(s) and accept the risks.

  • I do not hold the aesthetician responsible for any health or skin conditions present at the time of service. but not disclosed at the time of treatment which may be affected by any facial services performed.

  • I certify that this agreement will remain in effect for this procedure and all future

  • I CERTIFY THAT I HAVE READ THE STATEMENTS ABOVE TO VERIFY MY UNDERSTANDING AND CONSENT.

  • I FULLY ACCEPT THE RESPONSIBILITY FOR THE DECISION TO HAVE THIS WORK DONE AND GIVE MY PERMISSION TO MY AESTHETICIAN.

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