I hereby consent to and authorize Raylene Davis on behalf of Beauty and the Blend By Raylene to perform treatment/treatments.
I have voluntarily elected to undergo this treatment/procedure after the nature and purpose of this treatment has been explained to me, along with the risks and hazards involved, by Raylene Davis.
Although it is impossible to list every potential risk and complication, I have been informed of possible benefits, risks, and complications. I also recognize there are no guaranteed results and that independent results are dependent upon age, skin condition, 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 have read and understand the post-treatment home care instructions. 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 Raylene Davis immediately.
I have also, to the best of my knowledge, given an accurate account of my medical history, including all known allergies or prescription drugs, vitamins/supplements or products I am currently ingesting or using topically.
I have read and fully understand this agreement and all information detailed above. I understand the procedure and accept 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 Raylene Davis the esthetician or Beauty and the Blend by Raylene, responsible for any of my conditions that were present, but not disclosed at the time of this skin care procedure, which may be affected by the treatment/s performed today.
We understand that unanticipated events happen occasionally in everyone’s life. In our desire to be effective and fair to all clients, the following policies are honored:
Please aim to arrive 10 minutes before scheduled appointment time. If a client arrives after their scheduled appointment time; Depending upon how late a client arrives, we will then determine if there is enough time remaining to start treatment. If treatment is shortened due to client's late arrival, client will still be charged the full cost of the treatment. Out of respect and consideration to us and other customers, please plan accordingly.
24 hour notice is required to reschedule or cancel a booked appointment, This allows the opportunity for someone else to schedule an appointment. If clients are unable to give us 24 hours advance notice, they may be charged the full amount of their appointment at our discretion. This amount will be paid with the card on file and/or prior to their next scheduled appointment. Exception in cases of infectious or illness as described below:
If you, or another person in your household, has an infectious or contagious illness, please contact us as soon as possible to reschedule your appointment for a later date. There is no penalty in this case, for your safety and that of our other clients.
Clients who either forgets or consciously chooses to forgo their appointment for whatever reason will be considered a “no-show.” They will be charged the full amount for their “missed” appointment paid with the card on file and/or prior to their next scheduled appointment.
I agree to the policies described above.
Today's Date: June 4, 2020