Rezenerate Facial Consent Form
This form needs to be filled out in addition to the Facial & Waxing Consent Form.  Thank you!
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This  consent  form  is  between  the  Professional  Skin  Care  business:  PURE SKINCARE & ACNE SPA and YOU (“The  Client”).  The  Client  hereby  authorizes PURE SKINCARE & ACNE SPA  to  perform  a  facial  using  the  Rezenerate  Wand  and  Rezenerate  Chip.  The  Client  understands that the  number  of  facials  required  to  reach  anticipated  results  may  vary  and  that  potentially  several  facials  will  be  needed  to  achieve  the  desired  results.  The  Client  understands  that  there  may  be  some  degree  of  minor  discomfort,  such  as  scratchiness,  itchiness,  irritation,  hotness,  and/or stinging.The  Client  understands  that  it  is  normal  for  the  area  receiving  the  facial  to  appear  red  with  slight    swelling  after  the  facial,  similar  to  a  mild  sunburn,  which  can  last  a  few  days  after  the  facial.  The  Client  understands  that  the  facial  area  has  to  be  treated  gently  in  between  facials  and  that  the  correct  after-­‐care  advice  must  be  followed.  The  use  of  AHA’s  or  retinols  or  any  harsh  serums  is  not  recommended  until  the  area  is  fully  recovered.  Picking  at  the  facial area  may  result  in  poor  results  or  potential  scarring.  Additionally,  the  Client  understands  exposure  of  a  recently  treated  facial  area  to  excessive  sunlight  should  be  avoided  and  that  Client  should  utilize  a  reputable  sun  block  with  a  factor  30  of  protection  after  the  facial,  reapplied  throughout  the  days  following  the  facial.  The  Client  confirms  that  it  has  informed  the  Professional  Skin  Care  business  of  all  their  medical  conditions  relevant  to  receiving  the  facial.  The  Client  confirms  it  has  understood  all  the  information  given  regarding  the  facial  during  the  consultation  and  that  any  questions  they  had  have  been  answered  to  Client’s  satisfaction.    The  Client  represents  that  it  has  read  and  understood  this  consent  form  before  signing  it.  The  Client  further  agrees  that  it  for  each  and  every  facial  Client  receives  they  shall  have  been  deemed  to  have  acknowledged  and  agreed  to the  above  paragraphs. *
By selecting "Yes", I agree and understand the information provided.  We will be unable to provide a treatment if consent terms are not accepted.
PLEASE TYPE YOUR FULL NAME IN ALL CAPITAL LETTERS TO INDICATE YOUR SIGNATURE: *
Today's date: *
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