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INFORMED CONSENT: I understand that this is a cosmetic treatment and that no claims are expressed or implied. I understand that to achieve maximum results, I may need more than one treatment and I need to follow the maintenance home protocol. I understand that there are no guarantees as to the result of this treatment, due to many variables such as age, conditions of the skin, sun damage, smoking, and climate. I may or may not experience actual “peeling” with this procedure, as each case is individual.I understand that there is some degree of discomfort, i.e.: stinging, “pin-pricking” sensation, hotness, or tightness. I understand that although complications are very rare, sometimes they may occur and that prompt treatment is necessary. In the event of any complications, I will immediately contact Charlotte Savia. I agree to refrain from tanning or excessive sun exposure while I am undergoing treatment and 14 days after my treatment. I understand that direct sun exposure is prohibited while I am undergoing treatment and that the use of sun block protection with a minimum SPF 15 is mandatory I have revealed any medical condition that may affect the treatment such as pregnancy, cold sore tendencies, allergies, recent facial peels or surgery, types of contraindicated medications such as Accutane, hormone replacement therapy or use of Retin-A. Contraindicated medications should be discontinued five days prior to the treatment with the exception of Accutane which must be discontinued for six months prior to treatment. I have not had a peel treatment of any kind within 14 days. I understand I cannot have another treatment until recommended by a licensed professional. I understand my responsibility of properly fulfilling the appropriate after care instructions as explained by Charlotte Savia. I certify that all of the above information is true to the best of my knowledge. I understand that the services received here are not a substitute for medical care and any information given by the Esthetician is for education purposes only. I agree to all the policy terms stated above. If under 18 I will have a parent or guardian sign for me.