Repeat Skincare Intake Form

I understand the treatment(s) I am about to receive is provided by a licensed Esthetician who has undergone all the current state, county, city, and educational requirements necessary to perform these treatments. If I notice discomfort, pain, etc., I will notify my Esthetician immediately. I understand that the application of glycolic acid can cause temporary redness, peeling and mild discomfort and I need to limit sun exposure and use broad spectrum sunscreen during treatment. I also understand my treatments are not to take the place of a doctor’s examination, diagnosis, prescription, or treatment of a physical or mental illness or condition I knowingly or unknowingly currently have. I have to the best of my ability listed all known conditions, injuries, treatments, medications, past or present and hold LaVida Massage and its employees harmless for contraindications or injuries, whether physical or mental, by me not sharing my medical history. I agree to keep any Esthetician affiliated with LaVida Massage up to date on my health.