I am aware and fully understand the possible benefits, risks, side effects and complications of the procedures I have elected to undergo. I also understand that it is impossible to list every risk or potential complication of a particular procedure. To the best of my knowledge, I have provided to the company an accurate account of my medical history, allergies, and any prescription drugs which I am ingesting.
Client Initials I recognize there are no guaranteed results with any procedure and that independent results are dependent upon age, body condition, and lifestyle, and that there is the possibility I may require further treatments of the treated areas to obtain the expected results at an additional cost. I understand that the procedure is being performed by a technician and I am not being treated by a professional with any medical qualifications. I understand that the technician is not going to examine me for any health concerns and that I am assuming the risk of any potential complications from previous conditions I may have even if I am not aware of them. If I am pregnant I understand that I must first consult with my doctor prior to receiving any procedure(s). Spray Tanning Rider: I understand that the FDA has directed that all people who receive spray tanning treatment avoid inhaling or ingesting any materials used in the treatment/procedure. I am fully aware that when receiving the treatment it maybedifficult to avoid exposure to sensitive areas. I acknowledge that I have been made aware of precautionary measures which I may take in order to potentially minimize such exposure. If I choose not to take such precautionary measures I am making such choice of my own volition. I further understand that I will be provided with aftercare instructions and that it is my sole responsibility to follow said instructions in order to maintain the integrity of the spray tan.
Client Initials Teeth Whitening Rider: I am fully aware that the technician performing this procedure is not a dentist and possesses no formal dental qualifications. I understand that I should consult with a licensed dentist prior to treatment. I am also fully aware that multiple treatments could be required in order to obtain the desired results, and that veneers, porcelain, or other dental materials in my mouth cannot get any whiter than their original color. Finally, I understand that I am not a good candidate for this procedure if I have periodontal disease, fillings which are breaking down, or unfilled cavities.
Client Initials CBD/PCR Toner Treatment Rider: This product is not for use by or sale to persons under the age of 18. This product should be used only as directed on the label. It should not be used if you are pregnant or nursing. Consult with a physician before use if you have a serious medical condition or use prescription medications. A Doctor's advice should be sought before using this and any supplemental dietary product. All trademarks and copyrights are property of their respective owners and are not affiliated with nor do they endorse this product. These statements have not been evaluated by the FDA. This product is not intended to diagnose, treat, cure or prevent any disease.
Client Initials Waxing Rider: I understand that if I begin use or are currently using, Accutane,Retin-A, Differen, retinols, Renov-A,any product that causes skin sensitivity, have or had a recent sunburn, or use any medication or medical conditions that may cause adverse reaction I will not be waxed today. I accept full responsibility for any adverse effects or sensitivity if I choose to be waxed today despite these warnings. I understand that waxing may cause some temporary redness, bumps, or itching. Client Initials Authorization for Use of Photos and Images: I hereby grant permission for Shade & Seeker LLC to use photographs, provided by me by tagging @shadeadseeker on social media or authorized during my appointment and/or images of my completed treatment for use in marketing materials that include, but may not be limited to printed materials such as brochures and newsletters and digital images for use on Shade & Seeker’s website and social media outlets
Client Initials I have read and understand the post-treatment home care instructions for the elected procedure(s). I understand how important it is to follow all instructions given to me for post-treatment care. In the event that I may have additional questions or concerns regarding my treatment or suggested home product/ post-treatment care, I will consult the Company immediately. Refund Policy: If there is an issue with your final result, it must be reported and shown to us in-person within 24 hours of your appointment. We will happily work with you to remedy any perceived issue in a timely manner, but do not offer refunds under any circumstance. Deposits are non-refundable.
Client initials I have read and fully understand this agreement and all information detailed above. I understand the procedure and fully and voluntarily accepting the risks. All of my questions have been answered to my satisfaction and I consent to the terms of this agreement. I do not hold the Company or its employees and affiliates responsible for any of my conditions that were present, but not disclosed at the time of this procedure, which may be affected by the procedure performed today. Date: November 21, 2024
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