Prior to receiving treatment, I have been candid in revealing any condition that may have bearing on this procedure, such as: pregnancy (please consult with OB/GYN), recent facial surgery, allergies, use of Retin-A, Differin, birth control or hormone replacement. The use of the aforementioned may cause post-inflammatory pigmentation. This condition does not occur due to miracle peeling. If I do use these products or have these conditions, I will refrain from using high strength topical skin products for 3 to 5 days prior and after peeling.
- I understand there may be some degree of discomfort; ie. stinging, pinpricking sensations, hotness, or tightness for up to 72 hours.
- I understand there are no guarantees as to the results of a 30% AHA/BHA treatment because of outside variables such as: age, skin condition, sun damage, smoking, climate, etc.
- I understand I may or may not actually peel, that each case is individual.
- I understand this treatment is a cosmetic treatment and that no medical claims are expressed or implied.
- I understand that to achieve maximum results, several treatments may be needed.
- I understand that although a redness/rash is rare, sometimes it may occur and that I will follow the product protocol advised by my Skin Repair Consultant.
- I agree to refrain from tanning in tanning booths while I am undergoing treatment, and during 7 days following the end of treatment.
- I understand that direct sun exposure is not recommended while I am undergoing treatment and that the use of sun block protection with a minimum of SPF 15 is understood. Indirect sun exposure is permissible.
- I have not had any other peel treatment of any kind within 14 days of the treatment. I understand that I cannot have another treatment within 14 days of this treatment, whether the treatment is performed at this location or any other location.
- I understand that if I have been an Accutane patient I cannot receive any peel administered until 12 months after Accutane treatment has ended or prior to 12 months with doctor written permission.
- Clients allergic to aspirin must exercise CAUTION with Salicylic in our 30% Glycolic peel. Even though Salicylic is derived from Willowbark, Salicylic does have the potential to turn into aspirin if a large enough quantity enters the bloodstream.
I hereby agree to all of the above and agree to have this treatment performed on me. I further agree to follow all post-peel care instructions.
Disclaimer - Employees, officers and representatives of Tzone Enterprises Inc. (T4 Skin Care + H Skin Repair) assume no responsibility/liability for consequences/injuries/actions as a result of agreeing to receive a 30% Glycolic or H Amazing 30% Blended Peel or 50/50 Blended Mix. Peeling products are formulated to improve appearance and are in no way intended to diagnose, treat, cure, prevent disease or replace the advice of a qualified medical professional.
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