Wendy Jade Skin Care - Client Intake

Consent for Treatment
 
By completing this form, I confirm to the best of my knowledge that the answers I have given are correct and that I have not withheld any information that may be relevant to my treatment.  I will inform the therapist of any change in my health upon subsequent visits. I  understand that the services offered are not a substitute for medical care and that the esthetician does not diagnose, treat, or prescribe for any ailment, illness, or disease.  I give permission to my esthetician to perform the procedure we have discussed and will hold her harmless from any liability that may result from injury or unexpected result from this treatment.  I have read and will comply with the pre- and post-treatment instructions from the Wendy Jade website.  I will enter below my first and last initial plus today's date (MMDDYYYY) to signify my signature.
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