Although every precaution will be taken to ensure your safety and well being before, during, and after your treatment/procedure, please be aware of the following information and possible risks and indicate that you fully understand what to expect.
I hereby consent to and authorize the technician/esthetician to perform the following treatment/procedure
I voluntarily agree to undergo this treatment/procedure after the nature and purpose of this treatment/procedure has been explained to me, along with the risks and hazards involved.
Although it is impossible to list every potential risk and complication, I have been informed of possible benefits, risks, and complications.
I understand that it is imperative to my health and safety that I disclose all of the information requested in the Client Consultation/Health History form. I have cited all conditions and circumstances regarding my health history, allergies, and medications, supplements, or prescriptions being taken (orally and/or topically), and any past reactions to products or medications.
I understand that no specific guarantees of the results can or have been made and that there is the possibility I may require additional treatments/procedures to obtain theexpected results at an additional cost.
I have read and understand all pre treatment, post-treatment, and home care instructions. I understand the importance of following all instructions given to me. In the event that I have additional questions or concerns regarding my treatment or post-treatment care, I will consult the technician/esthetician immediately. I understand that if I choose to consult a physician, I do so at my own expense.
I consent to “before-and-after” photographs for the purpose of documentation, potential advertising, and promotional purposes.
I understand that if I have any concerns, I will address these with my technician/esthetician. I give permission to my technician/esthetician to perform the above treatment/procedure we have discussed and will hold him/her/them and his/her/their staff harmless and nameless from any liability that may result from this treatment/procedure. I understand my technician/esthetician will take every precaution to minimize or eliminate negative reactions as much as possible. I agree that this constitutes full disclosure, and that it supersedes any previous verbal or written disclosures. I certify that I have read and fully understand the above paragraphs and that I have been provided sufficient opportunity for discussion and to have any questions answered. I understand the procedure and accept the risks. I do not hold the technician/esthetician, responsible for any of my conditions that were present but not disclosed at the time of this procedure that may be affected by the treatment performed today.
I understand, have read and completed all required questionnaires truthfully. I agree that this constitutes full disclosure, and that it supersedes any previous verbal or written disclosures. I understand that withholding information or providing misinformation may result in contraindications and/or irritation to the skin from treatments received. The treatments I receive here are voluntary and I release this institution and/or the technician/esthetician/skin care professional from liability and assume full responsibility thereof.
Client Health History – General
I understand, have read and completed all required questionnaires truthfully. I agree that this constitutes full disclosure, and that it supersedes any previous verbal or written disclosures. I understand that withholding information or providing misinformation may result in contraindications and/or irritation to the skin from treatments received. I am aware that it is my responsibility to inform the esthetician/skin care therapist of my current medical or health conditions and to update this history. The treatments I receive here are voluntary and I release this institution and/or skin care professional from liability and assume full responsibility ther
Client Treatment Plan
If you have any questions about your treatment plan, or when and how to use your home care products, please contact me any time. Your treatment plan may change depending on the rate of progress and changes in your skin.
I understand that to achieve maximum benefits and maintain the results from my professional treatments, home care product use as outlined above is essential.
I commit to my success by pledging to wear sunscreen daily.
Covid-19 Screening & Consent
COVID-19 Consent for Treatment
To proceed with receiving care, I confirm and understand the following
I understand that the novel Coronavirus (COVID-19) has been declared a global pandemic by the World Health Organization (WHO). I further understand that COVID-19 is extremely contagious and may be contracted from various sources. I understand COVID-19 has a long incubation period during which carriers of the virus may not show symptoms and still be contagious.
I understand that I am the decision maker for my health care. To the best of their ability, my practitioner will provide me with information to assist me in making informed choices. This process is often referred to as “informed consent” and involves my understanding and agreement regarding recommended care, and the benefits and risks associated with the provision of health care during a pandemic. Given the current limitations of COVID-19 virus testing, I understand determining who is infected with COVID-19 is exceptionally difficult.
I understand that preventative measures and intensified sanitation protocols intended to reduce the spread of COVID-19 have been implemented. However, because this work involves close physical proximity over an extended period of time in a closed space, there may be an elevated risk of disease transmission, including COVID-19. I hereby acknowledge and assume the risk of becoming infected with COVID-19 through this treatment and give my express permission to you and the staff at your offices to proceed with providing care.
I have been offered a copy of this consent form.
I KNOWINGLY AND WILLINGLY CONSENT TO THE TREATMENT WITH THE FULL UNDERSTANDING AND DISCLOSURE OF THE RISKS ASSOCIATED WITH RECEIVING CARE DURING THE COVID-19 PANDEMIC. I CONFIRM ALL OF MY QUESTIONS WERE ANSWERED TO MY SATISFACTION.
I HAVE READ, OR HAVE HAD READ TO ME, THE ABOVE COVID-19 RISK INFORMED CONSENT TO TREAT. I APPRECIATE THAT IT IS NOT POSSIBLE TO CONSIDER EVERY POSSIBLE COMPLICATION TO CARE. I HAVE ALSO HAD AN OPPORTUNITY TO ASK QUESTIONS ABOUT ITS CONTENT, AND BY SIGNING BELOW, I AGREE WITH THE CURRENT OR FUTURE RECOMMENDATION TO RECEIVE CARE AS IS DEEMED APPROPRIATE FOR MY CIRCUMSTANCE. I INTEND THIS CONSENT TO COVER THE ENTIRE COURSE OF CARE FROM ALL PROVIDERS IN THIS OFFICE FOR MY PRESENT CONDITION AND FOR ANY FUTURE CONDITION(S) FOR WHICH I SEEK CARE FROM THIS OFFICE.
COVID-19 is a highly contagious virus that spreads from person to person. In addition to long-held and explicit sanitation measures this business has always adhered to, new preventative measures have been put in place to further reduce the spread of this novel coronavirus. However, these best practices still offer no guarantee regarding your potential risk of being infected.
I understand that, because esthetics involves maintained touch and close physical proximity over an extended period of time, there may be an elevated risk of disease transmission, including COVID-19. By signing this form, I acknowledge that I am aware of the risks involved from receiving treatment at this time, I voluntarily agree to assume those risks, and I release and hold harmless the practitioner/business from any claims related thereto. I give my consent to receive treatment from this practitioner.
COVID-19 Consent for Treatment
To proceed with receiving care, I confirm and understand the following (Initial in all places provided)
I understand that the novel Coronavirus (COVID-19) has been declared a global pandemic by the World Health Organization (WHO). I further understand that COVID-19 is extremely contagious and may be contracted from various sources. I understand COVID-19 has a long incubation period during which carriers of the virus may not show symptoms and still be contagious.
I understand that I am the decision maker for my health care. To the best of their ability, my practitioner will provide me with information to assist me in making informed choices. This process is often referred to as “informed consent” and involves my understanding and agreement regarding recommended care, and the benefits and risks associated with the provision of health care during a pandemic. Given the current limitations of COVID-19 virus testing, I understand determining who is infected with COVID-19 is exceptionally difficult.
I understand that preventative measures and intensified sanitation protocols intended to reduce the spread of COVID-19 have been implemented. However, because this work involves close physical proximity over an extended period of time in a closed space, there may be an elevated risk of disease transmission, including COVID-19. I hereby acknowledge and assume the risk of becoming infected with COVID-19 through this treatment and give my express permission to you and the staff at your offices to proceed with providing care.
I have been offered a copy of this consent form.
I KNOWINGLY AND WILLINGLY CONSENT TO THE TREATMENT WITH THE FULL UNDERSTANDING AND DISCLOSURE OF THE RISKS ASSOCIATED WITH RECEIVING CARE DURING THE COVID-19 PANDEMIC. I CONFIRM ALL OF MY QUESTIONS WERE ANSWERED TO MY SATISFACTION. I HAVE READ, OR HAVE HAD READ TO ME, THE ABOVE COVID-19 RISK INFORMED CONSENT TO TREAT. I APPRECIATE THAT IT IS NOT POSSIBLE TO CONSIDER EVERY POSSIBLE COMPLICATION TO CARE. I HAVE ALSO HAD AN OPPORTUNITY TO ASK QUESTIONS ABOUT ITS CONTENT, AND BY SIGNING BELOW, I AGREE WITH THE CURRENT OR FUTURE RECOMMENDATION TO RECEIVE CARE AS IS DEEMED APPROPRIATE FOR MY CIRCUMSTANCE. I INTEND THIS CONSENT TO COVER THE ENTIRE COURSE OF CARE FROM ALL PROVIDERS IN THIS OFFICE FOR MY PRESENT CONDITION AND FOR ANY FUTURE CONDITION(S) FOR WHICH I SEEK CARE FROM THIS OFFICE.
This contract outlines the policies and procedures for services provided at our office. By signing below, you acknowledge that you have read and understood this information.
Appointment Scheduling & Cancellations:
Tardiness Appoinment times are as scheduled and cannot extend beyond the stated time to accommodate late arrivals. Please be on time to your appointment.
Sickness Skin care and other esthetic services are not appropriate care for infectious or contagious illness.
Scheduling Appointments can be made by phone, email, or online booking system. A credit card number may be required to hold the appointment.
Cancellation We require a minimum of 24 hours’ notice to cancel or reschedule an appointment without a fee. Late cancellations or no-shows will be charged the full appointment price. You are responsible for paying the missed appointment/late cancellation fees. **Waive Fee: Appointments rescheduled within 24 hours due to sickness or emergency, fee will be waived as a one-time courtesy.
Client Intake Form: A new client intake form must be completed before your first service. Please disclose any allergies, medical conditions, medications, or recent surgeries that may impact your service.
Consultation: A consultation will be conducted before each service to discuss your skin concerns, goals, and suitability for the desired treatment.
Service Pricing & Payment Current service prices are listed on our website and in our office brochure. Prices are subject to change.
Payment: Payment is due at the time of service. We accept Zelle, cash, credit cards, and debit cards. Gratuities are always appreciated.
Gift Certificates:
Gift certificates are available for purchase and make excellent gifts. Gift certificates are non-refundable but may be used towards any service at Elev8 Esthetics.
– Expired gift certificates will not be honored.
– Elev8 Esthetics is committed to providing a professional and relaxing environment for all clients.
– We ask that clients arrive on time for appointments and dress appropriately for services.
– Disruptive or abusive behavior will not be tolerated. Management reserves the right to refuse service to any client.
Elev8 Esthetics respects your privacy. All client information will be kept confidential and will not be shared with third parties without your written consent.
Client Responsibility
– Clients are responsible for disclosing all relevant medical history and allergies.
– Clients are responsible for following pre- and post-treatment instructions provided by their esthetician.
– Clients should inform their esthetician of any changes in their health or medications before their appointment.
Disclaimer:
Skincare results may vary depending on individual factors. Elev8 cannot guarantee specific outcomes from any treatment. We recommend a series of treatments for optimal results.
Governing Law:
This Contract shall be governed by and construed in accordance with the laws of the State of Florida.
Agreement:
By signing this contract, you agree to the policies and procedures outlined above.
We appreciate your business. So that we can best serve all our clients, please be advised of these policies.
ARRIVAL TIME
Please aim to arrive 10 minutes before your scheduled appointment time. If you arrive after your scheduled appointment time, it may not be possible to extend the time available for your booked service; if your service is shortened due to your late arrival, you may still be charged the full cost of the service.
CHANGING YOUR APPOINTMENT
24 hours’ notice is required to reschedule or cancel a booked appointment, except in cases of contagious illness as described below.
SICKNESS OR FAMILY EMERGENCY
If you, or another person in your household, has an infectious or contagious illness, please contact us as soon as possible to reschedule your appointment for a later date
I agree to the policies described above.
Treatment Photos Consent
This Treatment Photos Consent Contract (“Contract”) outlines the terms and conditions for the use of photographs taken during your treatment with Elev8 Esthetics (“Business”).
Consent:
I grant the Business the non exclusive, irrevocable, royalty-free right to use photographs (collectively, “Photos”) taken during my treatment for the following purposes: Marketing and promotional materials, including the Business website, social media platforms, and printed brochures. Educational purposes, such as presentations or workshops.
Limitations:
The Business will not use Photos that could identify me without my written consent. This may include blurring my face, removing identifiable features, or using only close-up shots that exclude my face.
Photos will not be used in any defamatory or misleading manner.
Right to Withdraw Consent:
I understand that I have the right to revoke this consent at any time by submitting a written request to the Business.
However, the Business reserves the right to continue using Photos already published or distributed before receiving my withdrawal request.
Ownership:
The copyright to the Photos remains with the Business.
Release:
I hereby release the Business from any and all claims, demands, or liabilities arising from the use of Photos in accordance with this Contract.
IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the day and year first above written.