I understand that this form and it's data are completely confidential. The information I have provided regarding my medical history is accurate to the best of my knowledge, and I affirm I do not have any ailments or conditions that would make this treatment/procedure incompatible with my health and wellbeing. By signing this form, I certify that I am at least 18 years of age and fully competent to give my consent; that I have been given the opportunity to ask any questions I may have, and those questions have been answered. I acknowledge the information given to me pertaining to the requested treatment(s)/procedure(s), and I have been sufficiently informed of the benefits and risks involved. I agree to inform my Esthetician/Technician if I experience any pain, discomfort, or sensitivities during treatment, allowing for them to make the appropriate adjustments. I agree to waive all liability towards my Esthetician/Technician and Wild Heart Aesthetics, for any possible harm or injury in the case of my failure to disclose any and all/past and present health conditions.
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