Client Consent Form
1. I acknowledge that I have not used Accutane or any medication for the same purpose during the last 12 months
2. I acknowledge that if I have ever had a cold sore or fever blisters, I should consult with my physician or pharmacist for a pre-use medication to help avoid a possible breakout. That medication should be used each day or two days before, same day and two days after any aggressive facial exfolation treatment.
3. I acknowledge that there is no guarantee that dark discoloration of skin will be reduced or fade. Appearance of pigmentation may improve or darken with successive treatments. I acknowledge the need for proper skin care home regimen
4. I acknowledge that my skin might experience temporary irritation, tightness, or redness which usuall dissipates within 72 hours depending on skin sensativity
5. I acknowledged that if I am allergic to one or more of the ingrediants in the products used, I may experience allergic reactions
6. I acknowledge that if I fail to use a minimal sunscreen (SPF 30) and follow the direction for use, I am more susceptible to suburn, sun damage and hyperpigmentation. I should avoid excessive sun exposure, especially between 10am-2pm.
7. I acknowldge that this treatment is strictly an eelctive cosmetic procedure and that no medical claims have been expressed or implied
8. I acknowledge that I should avoid use of aggressive exfoliation, waxing, and products containing acids that are not part of recommended take-home regimen for 2-4 weeks following the treatments
9. I acknowledge that I should avoid use of Retin-A type products for a period of time recommended by my physician or skin care practioner during the following treatment
10. I acknowledge that I am not pregnant or lactating
11. I hereby agree to have the treatment performed and agree to follow all pre and post treamtent instructions
12. I acknowledge that I have answered all questions truthfully
13. I release Edge Systems, Lisa Primps, management and staff of The Primping Place from any and all liability associated with any injuries and/or current or future coniditions resulting from the skincare procdures or products
By signing below, I certify that I have read and fully understood the contents of this consent form, and that the information I provided above are complete, accurate and up to date to my knowledge.