Facial Consent Form Facial Consent Form I confirm I am at least 18 years of age I have elected, by my own decision, to have a facial treatment performed on me The treatment, including the process and objective, has been explained to me before undergoing a facial I have been given the opportunity to ask questions regarding any benefits, risks, or possible complications of the treatment I understand and acknowledge any risks or complications associated with the procedure as they’ve been explained to me I understand the treatment may be uncomfortable at times and I may experience unusual sensations I have followed all pre-procedure care instructions, as explained to me I understand all aftercare procedures and I intend to adhere to them I understand I should use sunscreen (SPF 30) following treatment I understand I should avoid the use of Retin-A type products I understand complications are rare but possible and will contact the provider if needed I understand I should avoid aggressive exfoliating, waxing, and acid products for 2–4 weeks I understand facials are elective procedures and are not medically necessary With my signature below, I confirm that I have read fully and understand the information in this consent form and all details included. I have provided an accurate account of my medical history including any medications I take or intend to take, any medical procedures I intend to undergo. By signing below, I agree to accept all and full responsibility for any risks, injuries, damages, or side effects that may occur as part of the procedure. I will not hold my facial provider (name recorded below) responsible for any conditions present, but not disclosed at the time of treatment, that may affect the treatment. Printed Client’s Name: Provider’s Name: Client Signature: Date: Provider Signature: Date:
