I have been advised the service(s) provided to me by this salon could have unfavorable results including, but not limited to: allergic reaction, burning, irritation, lifted skin, soreness, ect . I am aware that certain medications and over the counter products can significantly increase the risk of injury when combined with skincare services for clients using Blood Thinners, Steroids, Chemotherapy, Accutane, Renora, Retin-A and products containing Alpha Hydroxy or any skin thinning treatments. *

I hereby confirm that I am not using medications that may cause or contribute to such injury/infection, and I will advise my esthetician should I use any such medications in the future. I understand there are often inherent risk associated wiht skin care services, and I agree that as a condition of providing these services on an ongoing bases, I will not hold my Esthetician or Rayo Esthetics Liable. *

You are consenting to this client under the age of 18 to receive treatment please check and sign below.