​I have voluntarily elected to undergo this treatment/procedure by a supervised trainee. The nature and purpose of this treatment has been explained to me, along with the risks and hazards involved. I am happy to undergo the treatment by somebody who is currently working toward their qualifications.

​Although it is impossible to list every potential risk and complication, I have been informed of possible benefits, risks, and complications. I also recognise there are no guaranteed results and that independent results are dependent upon age, skin condition, and lifestyle and that there is the possibility I may require further treatments of the treated areas to obtain the expected results at an additional cost.

​I have read and understand the post-treatment home care instructions. I understand how important it is to follow all instructions given to me for post-treatment care. In the event that I may have additional questions or concerns regarding my treatment or suggested home product/post-treatment care, I will consult the trainee/tutor immediately.

​I have also, to the best of my knowledge, given an accurate account of my medical history, including all known allergies or prescription drugs or products I am currently ingesting or using topically.

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 this agreement.

​I do not hold the trainee/or training school, whose signature appears below, 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.

​*YOU WILL BE TAKING FULL RESPONSIBILITY FOR THE TREATMENT AND WILL BE ASKED TO SIGN AND DATE THE ABOVE