I herby consent to Authorize Jennifer Dowling to perform the following procedure
I have voluntarily elected to undergo this treatment/procedure after the nature and purpose of this treatment has been explained to me, along with the risks and hazards involved.
Although it is impossible to list every potential complication, I have been informed of possible benefits, risks, and complications. I also recognize there are no guaranteed results and that independent results vary based on age, skin condition, and lifestyle and that there is the possibility I may require further treatments to obtain expected results at an additional cost.
I understand the post-treatment home care instructions. I understand how important it is to follow all instructions given to me. In the event that I may have additional questions or concerns I will reach out to Jennifer immediately.
I have read and fully understand this agreement and all information detailed above. I understand the procedure and accept the risks. All of my questions have been answered to my satisfaction and I consent to the terms of the agreement. I do not hold the esthetician responsible for any of my conditions that were present but not disclosed at the time of this skin care procedure, which may be affected by the treatment performed today.
