Consent for Treatment
By contacting, booking, or scheduling an appointment requires that you acknowledge a consent for treatment. All products and services will be explained prior to being performed.
Consent for Use of Chemical Exfoliators
By requesting to book services you are consenting for treatments to be performed. These treatments may include: AHA Active Exfoliator, Jessners Solution, lactic Action Exfoliator, Sal-X 20%, Physician Elite Rx™ Sal-X 30%, DermaSound™ Elite, 5-Berry Pigment Control Peel, Vitamin A Professional Power Peel, Professional TCA Peel 15% Solution, Physician Elite Rx™ AHA Active Exfoliator, Physician Elite Rx™ TriPeel (50%, 60%, or 70%), Intense Anti-Oxidant Professional Exfoliator, or Chocolate Power Skin Rescue Peel, or other products available to Shannon.
Shannon advises the treatment you will receive is ONLY available through a licensed and trained skin care professional. All treatments performed are immediately effeective and produce long-term results when all directions, as advised by Shannon and product manufacturers, are adhered to. These special non-invasive skin performance treatments remove the outer layers of micro damaged skin-signaling new cells to emerge, increasing collagen, elastin and hydration levels thereby producing clearer and more younger looking and acting skin. Additional benefits may include the drying of acgive acne, dislodging or purging of blackheads, reduction of superficial wrinkles or scarring, improving the appearance of mature or aging skin correcting skin damage, lightening pigmentation disorders such as sun or age spots, and controlling the effects of other health and aging skin challenges.
COMPLIANCE in your skin care program will determine the level of success and outcome of your treatment. Effective, long term results are dependent upon you. Consistency with your recommended continuance of home skin care products exclusively prescribed by your licensed skin care professional, Shannon, cannon be emphasized enough.
It is STRONGLY ADVISED you continue your professional in-clinic appointments as scheduled. Report any changes in health, diet, lifestyle or any reactions to your aesthetician or physician. Apply sunscreen as directed by your aesthetician, avoid excess sun exposure and avoid tanning beds. Inform your aesthetician of any recreational plans for the week following your treatment.
No guarantee is made or implied regarding results, peeling times or level of discomfort. Your treatment may involve the application of several peels at one, two or four week intervals, as determined by your aesthric/professional technician. It may include the use of skin brightening agents and sun-protection products. Shannon and the product manufacturers advise a patch test (for a small fee) applied behind the ear to gauge possible reactions.
Depending on your treatment, you may experience some temporary discomfort, including stinging or warm flushing, similar to a mild burning sensation. This is NORMAL and generally fades within five minutes. During the few minutes following the initial treatment, you will experience tightening of the skin to varying degrees. The skin can appear red and become aggressively rosier, occasionally turning a tan to brown color, depending upon formula and application variances.
Consent for Micro-Needling Treatment
Micro-Needling should not be performed until all risks and after effects are explained. It is advised that the patient receive approval from their heathcare prvider before treatment.
By requesting, or booking services through this website or with Shannon you are confirming that you will have a full consultation with Shannon regarding your micro-needling treatment course. A pamphlet on the treatment and after effect of said treatment will be provided to your by Shannon at the time of service.
You are acknowledging that you understand that micro-needling is used to treat acne scars, wrinkles and firming of the skin. I have been examined by my physician and cleared for this procedure.
By requesting the micro-needling service you acknowledge that most patients look as though they have a moderate to severe sunburn and your skin may feel warm and tighter than usual after treatment. Most patients usually recover within 24 hours of less. Because the device may penetrate the skin, there can be a risk of infection, if this occurs; a follow up appointment will be required for further treatments at an additional cost.
Your micro-needling treatment may not be used directly on any of the below conditions. By requesting a micro-needling service you acknowlege that you must disclose any of the following health concerns that apply to you:
Open Sores/Lesions/Broken or Irritated Skin
Skin Cancer/Radiation Treatment
Active Acne
Skin Infections
Rosacea
Eczema
Keloids
ANY Cosmetic Treatments that have occurred in the previous 28 days prior to treatment.
Additional consent forms may be required prior to treatment.
Consent to Take & Publish Photographs
In connection with skin care services received by Shannon’s Serendipity Skin Care photographs may be taken before and after treatments, and during the course of longer treatments, of clients, or parts of clients bodies, under the following conditions:
1. The photographs shall be used for medical records. If, in the judgement of my skin care professional, physician, education or science will be benefited by their use or the use by Shannon’s Serendipity Skin Care, such photographs relating to my case, may be published and/or republished, either separately or in connection with each other, in professional journals, medical books, skin care magazines, slides, or use for any purpose which she may deem proper in the interest of medical educatin, knowledgle, or research, provided howerever; it is specifically understood that in any such publication our use the client shall not be identified by name.
2. The aforementioned photographs may be modified or retouched in any way my skin care therapist at her discretion, may consider desirable.
