Loading...

The instructions and guidelines provided in this informed consent should be followed by all individuals receiving a professional service. Please read and initial after each paragraph acknowledging that you have read and understood all of the information presented.

PROFESSIONAL ESTHETIC IN-CLINIC SERVICE

  1. This professional esthetic in-clinic service is designed to improve the texture and appearance of your skin. Your participation in your service will determine the outcome. It is important that you strictly adhere to all instructions that your skincare therapist will provide.
  2. Depending on the service, you may experience some temporary erythema, irritation, or warm flushing. During the next few hours, you may experience some tightening of the skin which may last for several days.
  3. For some individuals, a light flaking begins within 48 hours. It is impossible to pre-determine how much flaking will occur.
  4. Depending on the service, the sloughing process usually subsides within 2-7days.
  5. Pigment may appear darker on the surface before fading.
  6. Lack of flaking or “peeling”is NOT an indication that the service was unsuccessful. If you do not notice actual peeling, you are still receiving all the benefits of your service such as improvement of skin tone, texture, and appearance of fine lines and hyperpigmentation. There are a number of reasons why some people may not experience peeling.
  7. Results may vary with each service and individual client. 

I ACKNOWLEDGE I DO NOT HAVE THE FOLLOWING

  • I am not pregnant.
  • No sunburns in the last 7 days
  • Not allergic to aspirin 
  • Active cold sores
  • Not taken Accutane (or its generic form) within the last 6 months
  • No new allergies or sensitivities since my last visit 

I Agree

PRE-SERVICE GUIDELINES - Unless otherwise instructed to do so by your skincare therapist:

1. I acknowledge I have followed the pre-service guideline of: One week prior to service avoid waxing, electrolysis, Laser Hair Removal, prescription retinoids/retinoid-like compounds (Retin-A, Renova, Differin, Tazorac), products containing any exfoliating agents that may sensitize the skin.



2. Please advise of any medical cosmetic facial procedures within the last 14 days.


POST SERVICE GUIDELINES - Post care is the continuation of your in-clinic service. 

1. It is essential to follow the post service home care program as recommended by your skincare professional. This will include daily SPF protection. 



2. Avoid direct sun exposure, strenuous exercise, or high amounts of heat including saunas and hot tubs. 



3. Do not pick or pull the skin. 


4. Immediately notify your skincare therapist of any concerns.  


CONSENT

I hereby give my consent & authorization, and voluntarily release Oliver Finley Academy of Cosmetology from any claims implied or stated that I have or may have in the future with this service, regardless of result. I am stating that the service and precautions above have been explained to me in detail and that I fully understand. If I am under the care of a physician, I have discussed the service plan with my physician for prior approval. 

Date: November 23, 2024

First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Parent(s) or Court-Appointed Legal Guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!