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Although it is impossible to list every potential risk and complication, the following conditions are recognized as contraindications for dermaplaning treatment and must be disclose prior to treatment.

Check all that Apply

Active Acne

Any Active Infections

Any Raised Lesions

Any Recent Checmical Peel Procedures

Botox or Cosmetic Filler Injections within 2 weeks

Family History of Hypertrophic Scarring or Keloid Formation

Hemophilia

Hormonal Therapy that produces think Pigmentation

Moles

Pregnancy

Oral Blood Thinner Medications

Recent use of topical agents such as Glycolic Acids or AHA or Retin-A

Rosacea

Scleroderma

Sunburn

Skin Cancer

Diabetes

Use of Accutane within the last year

Skin Disease /Skin Lesions

Chemotherapy or Radiation

Eczema or Dermatitis

Please read the following information carefully and check the appropriate boxes to show your understanding and acceptance: *

I understand that the treatment may involve the risk of injury and freely assume those risks. Possible side effects of the treatment area can include mild redness of the skin irritation and dryness. Additionally nicks to the skin can occur due to the sharp surgical blade. Clients will be notified and the area will be treated if necessary. The hair is expected to grow back blunt-ended. New hair will not appear darker or denser however I do understand that any hormonal imbalance that may be present within my anatomical system can alter my normal hair growth pattern.

I hereby release Bare Bronze Beauty against any and all liability associated with this procedure. I have been adequately informed of the risks and benefits of this treatment and wish to proceed with the treatment.

My name below, I acknowledge that I have read and fully understand this agreement and all the information detailed above.

Name *

First Name

Last Name

Date *

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