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Dermaplaning Consent Form

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Do you have the tendency to keloid scar on the face?
Do you currently have an active bacterial, fungal, or viral skin infection on the face, including herpes simplex (cold sore)?
*if yes, the procedure will be rescheduled.
Have you used Accutane in the last six months?
Have you had Botox and/or Juvederm or any other filler in the last three weeks?
Have you had any waxing of your brows, upper lip or face in the last 72 hours?
Cleanser:Toner:Eye Cream:Serum:Sunscreen:
I understand the following statements:
LACK OF EFFECT: although most people experience peeling of their facial skin, not every client notices that their skin peels after a Peel procedure. Lack of peeling is NOT an indication that the peel was unsuccessful. If you do not notice actual peeling, please know that you are still receiving all the benefits of the Vitalize Peel, such as: stimulation of collagen production, improvement of skin tone and texture, and diminishment of fine lines and pigmentation.
I agree and adhere to all safety precautions and regulations during the skin treatment. I have received and understand the post care recommendations as follows: no sun exposure for 48 hours, moisturize as needed and use gentle cleanser only. Use of sunscreen is highly recommended post-treatment for at least next 7 days. (SPF 30)

Cancellation Policy

48 hrs of cancel or reschedule are required, No shows, late cancel or late reschedule will be charged the full price of the service you are receiving not including any discounts. An active credit card is require when booking any appointment. If using any kind of coupon (groupon, living social, or any other coupon) that coupon will be forfeited and your credit card will be charged the remaining amount of the service before your coupon. Multiple late cancelations or reschedules could result in no longer being able to make appointments or require a non-refundable deposit.