Chemical Peel Form

Chemical Peel
Intake Form

Please fill out this form prior to your appointment date.

Chemical Peel Form

Eyelash Extension Form

Full Name

Phone Number

Referred By

Please Read & Check the Boxes in Acknowledgement

The treatment was explained to me in detail.

The benefits of what I can realistically expect to see from my chemical pee/enzyme treatment have been fully explained to me.

I understand that the treatment I am receiving is a treatment designed to exfoliate or remove the outer layer of the skin.

I understand that my skincare treatments and care at home will determine the outcome of my treatment. I understand that it is important that I adhere to my home-care products that my Esthetician has recommended.

I have received my post-treatment care guideline form.

I understand that there is no guarantee that is expressed or implied as to the precise results, peeling times, or discomfort.

I understand that during the treatment, I may experience some temporary stinging or warm flushing. This will fade within a few minutes. During the next few hours, I may experience some tightening of the skin, which may last for several days.

I understand that for most clients, flaking of the skin begins within 48 hours. I also understand that it is impossible to pre-determine how much peeling will occur. The shedding process usually subsides within 5-7 days.

I understand NOT ALL chemical peels/enzyme treatments will cause "peeling/flaking" and understand the act of "peeling/flaking" is not a way to determine the effectiveness of the treatment.

I understand that depending on the treatment and my skin quality, the following reactions may occur: 1) Prolonged redness, irritation, and flakiness 2) Dryness and sensitivity 3) Severe allergic reactions in rare instances.

I am of sound mind and am fully capable of executing this waiver for myself.

I give The Sunny Method permission to show my before and after photos to other potential clients and/or on social media.

I hereby give my consent and authorization voluntarily and release Sunny Flake with The Sunny Method from any claims, implied or stated that, I have or may have in the future with this treatment, regardless of result. I am stating that the treatment and precautions above have been explained to me in detail and that I fully understand.

Your Signature

Today's Date

We look forward to seeing you soon!

OTHER APPOINTMENT FORMS

Appointment Forms

Please print and fill out form specific to the service that

you will receive prior to your appointment.

Initial Consultation Form

Eyelash Extension Form

Chemical Peel Intake Form

Chemical Peel Form

Please Read & Check the Boxes in Acknowledgement

OTHER APPOINTMENT FORMS

Chemical Peel
Intake Form