Confidential Health History Update

  • I have confirmed that there have been no changes to my health history and I have not started any new medications since my last visit. 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 the the skin from treatments received. I am aware that it is i my responsibility to inform my skin care therapist of my current medical or health conditions and to update this history. The treatments I receive hear are voluntary and I release this institution and/or skin care professional from liability and assume full responsibility thereof.
  • I have confiremd that there have been changes to my health history since my last visit and have made note of those changes below. 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 the the skin from treatments received. I am aware that it is i my responsibility to inform my skin care therapist of my current medical or health conditions and to update this history. The treatments I receive hear are voluntary and I release this institution and/or skin care professional from liability and assume full responsibility thereof.
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