Dermaplane Consent & Liability Form 

the undersigned, acknowledge and agree to the following terms and conditions before receiving Dermaplane Facial Services from Uncommon Esthetics LLC, located inside Simplicity Spa Suites.

1. Assumption of Risk & Benefits:

I understand that a Dermaplane Facial is a professional exfoliation treatment involving the use of a sterile, surgical scalpel to remove dead skin cells and fine vellus hair (peach fuzz). I acknowledge that:

✔ The benefits may include smoother skin, improved texture, enhanced product absorption, and a brighter complexion.✔ The potential risks include, but are not limited to:*

• Temporary redness, irritation, or sensitivity

• Minor cuts, abrasions, or nicks

• Possible breakouts or mild skin reactions

• Increased sun sensitivity

I understand that these services may also include cleansing, exfoliation, extractions, massage, mask application, and the use of professional skincare products.*

2. Medical Disclosure & Personal Health Responsibility:

I confirm that I have:

✔ Disclosed any medical conditions, allergies, or skin sensitivities that may affect my treatment.

✔ Not used retinol, Accutane, or chemical exfoliants within the timeframe recommended by my service provider.

✔ No active cold sores, infections, or open wounds in the treatment area.

I acknowledge that it is my responsibility to inform my service provider of any changes in my health or medications before each session.*

3. Informed Consent for Treatment:

I consent to receiving a Dermaplane Facial performed by a licensed professional at Uncommon Esthetics LLC. I understand that my service provider will use their professional expertise to perform this treatment safely.*

4. Aftercare Agreement:

I agree to follow the aftercare instructions provided, including:

✔ Avoiding sun exposure and wearing SPF daily.

✔ Not applying harsh skincare products (retinol, acids, or exfoliants) for at least 48 hours.

✔ Keeping my skin clean and hydrated to minimize irritation.

I understand that failure to follow aftercare instructions may lead to adverse effects, for which Uncommon Esthetics LLC is not responsible.*

5. Release of Liability & Hold Harmless Agreement:

In consideration of receiving dermaplane facial services, I, on behalf of myself, my heirs, executors, administrators, and assigns, hereby waive, release, and discharge:

• Uncommon Esthetics LLC, its owner (Desiree Luzano), employees, affiliates, and Simplicity Spa Suites from any and all claims, liabilities, injuries, losses, damages, or adverse reactions that may occur during or after the service.

• Any liability for unforeseen reactions due to my in

*

I confirm that I am receiving this treatment voluntarily and at my own risk.

*

6. Agreement to Terms & Signature:

By signing below, I confirm that:✔ I have read and fully understand the terms and conditions of this liability waiver.

✔ I have had the opportunity to ask questions and have received satisfactory answers.

✔ I voluntarily agree to release all liability related to the service.

*

Yes, subscribe me to your newsletter.