I acknowledge that I have been informed of the potential risks and side effects, which may include but are not limited to:

• Redness, swelling, or mild discomfort
• Temporary darkening or lightening of the skin (hyperpigmentation or hypopigmentation)
• Blistering or scabbing
• Skin sensitivity or irritation
• Allergic reaction or infection (rare)
• Unsatisfactory results or need for further treatments

I confirm that I have received and understand all pre- and post-treatment care instructions provided by the clinic. I agree to follow these instructions carefully to reduce the risk of adverse effects and to enhance treatment outcomes.

I certify that I have disclosed all relevant medical history, including:

• Skin conditions or sensitivities
• Medications (including antibiotics or Accutane)
• Recent sun exposure or tanning
• History of cold sores/herpes simplex
• Pregnancy or nursing status

I understand that failure to disclose relevant medical information may increase the risk of complications.

I understand that results vary based on skin type, condition, and individual response, and that no specific outcome is guaranteed. Additional sessions may be needed for desired results.

I voluntarily consent to this treatment and assume full responsibility for any risks, injuries, or adverse effects that may result. I release and hold harmless Pearl Peau, its staff, and affiliated personnel from any liability for any claims or damages that may arise from the treatment or associated care.

The purpose of this procedure is to diminish or remove unwanted hair.  The procedure requires more than one treatment and may produce permanent hair removal.   The total number of treatments will vary between individuals.  On occasion there are patients that do not respond to treatments.  The treated hair should exfoliate or push out in approximately 2-3 weeks.

Alternative methods are waxing, shaving, electrolysis, and chemical epilation.

The following problems may occur with the hair removal system.

1. There is a risk of scarring.
2. Short term effects may include reddening, mild burning, temporary bruising or blistering.  Hyper-pigmentation (browning) and Hypo-pigmentation (lightening) have also been noted after treatment. These conditions usually resolve within 3-6 months, but permanent color change is a rare risk. Avoiding sun exposure before and after the treatment reduces the risk of color change.
3. Infection: Although infection following treatment is unusual, bacterial, fungal and viral infections can occur. Herpes simplex virus infections around the mouth can occur following a treatment. This applies to both individuals with a past history of herpes simplex virus infections and individuals with no known history of herpes simplex virus infections in the mouth area. Should any type of skin infection occur, additional treatments or medical antibiotics may be necessary.
4. Bleeding: Pinpoint bleeding is rare but can occur following treatment procedures. Should bleeding occur, additional treatment may be necessary.
5. Allergic Reactions: In rare cases, local allergies to tape, preservatives used in cosmetics or topical preparations have been reported. Systemic reactions (which are more serious) may result from prescription medicines.
6. I understand that exposure of my eyes to light could harm my vision. I must keep the eye protection goggles on at all times.
7. Compliance with the aftercare guidelines is crucial for healing, prevention of scarring, and hyper-pigmentation.

Occasionally, unforeseen mechanical problems may occur and your appointment will need to be rescheduled. We will make every effort to notify you prior to your arrival to the office. Please be understanding if we cause you any inconvenience.

ACKNOWLEDGMENT:

I acknowledge that my questions regarding the procedure have been satisfactorily answered. I have a clear understanding of the procedure and the associated risks, and I accept them.

By signing this release, I release Pearl Peau Corp, including the facility and technician, from any liabilities associated with the indicated procedure.

I acknowledge that I have received and understand the pre- and post-treatment care instructions.

I have read and understood all information presented to me before signing this consent form.

By choosing to receive Roller Massage Therapy and related services from Pearl Peau Corp and using its equipment and facilities, I acknowledge and accept the potential risks involved. I confirm that I am voluntarily participating in these services and agree to follow all posted guidelines, verbal instructions, and safety protocols provided by Pearl Peau staff.

If, in the opinion of Pearl Peau staff, I appear to be at physical risk, I understand that the company may require a letter from my physician (at my own expense) confirming I am fit to proceed with treatment.

I hereby:

1. Assume full responsibility for any injury or condition that may occur as a result of receiving the services;
2. Release and hold harmless Pearl Peau Corp, its owners, affiliates, employees, and agents from any liability, claims, or damages arising from or connected to the services;

I understand that I should consult a physician before receiving treatment if I have or may have any of the following:
Pregnancy or breastfeeding
Blood clots (DVT), phlebitis, clotting disorders
Severe varicose veins
Heart conditions
Cancer treatment within the past 5 years
Surgery in the past 3 months
Open wounds or skin issues in the treatment area
Tingling, redness, or pain in limbs
Epilepsy
Use of blood thinners

For Facial Roller Massage:
Botox or dermal fillers within the last 30 days
Active acne or facial skin conditions
I acknowledge and consent that I may be photographed or recorded during my visit for safety, training, or marketing purposes. Pearl Peau Corp will own all rights to these recordings. Identifying features will be removed from any marketing material unless the face is specifically being shown (e.g., for facial treatments).

CANDELA GLACE™ HYDRO-DERMABRASION

INFORMED CONSENT & RELEASE OF LIABILITY

1. TREATMENT DESCRIPTION

The Candela Glace™ Hydro-Dermabrasion treatment offered at Pearl Peau is a non-invasive cosmetic skin resurfacing procedure that combines gentle exfoliation, cleansing, suction, hydration, and infusion of topical serums to improve the appearance of skin texture, tone, and hydration. The treatment utilizes a specialized device and solutions designed to remove dead skin cells, unclog pores, and temporarily enhance skin radiance.

I understand that this is a cosmetic procedure, not a medical treatment, and that results vary based on individual skin condition, skin type, lifestyle, and adherence to pre- and post-treatment care instructions.

2. EXPECTED BENEFITS (NO GUARANTEE)

Potential benefits may include:

• Improved skin smoothness and texture
• Enhanced hydration and luminosity
• Temporary reduction in superficial congestion, dullness, and the appearance of pores or fine lines

I understand that results are not guaranteed, may be temporary, and that multiple treatments may be recommended to achieve or maintain desired outcomes.

3. POSSIBLE SIDE EFFECTS AND RISKS

I understand that while the Candela Glace™ treatment is generally well tolerated, I may experience side effects including, but not limited to:

• Temporary redness or flushing
• Mild swelling or skin sensitivity
• Tightness, itching, irritation, dryness
• Skin peeling or flaking
• Temporary breakouts or purging as pores are cleansed

These effects typically resolve within a few hours to several days; however, individual responses vary, and rare or unforeseen reactions may occur.

I agree that if I experience pain, discomfort, or unusual sensations during the treatment, I will immediately inform the practitioner so that treatment settings, products, or techniques may be adjusted or the procedure discontinued.

4. CONTRAINDICATIONS & CLIENT DISCLOSURE

I acknowledge that I should not receive this treatment unless cleared by a qualified medical professional if I have or have had any of the following:

• Active skin infections, open wounds, cold sores, or lesions in the treatment area
• Severe acne, eczema, psoriasis, dermatitis, or compromised skin barrier
• Recent chemical peels, laser treatments, microneedling, or aggressive exfoliation
• Known allergies or sensitivities to skincare ingredients used during the treatment
• Pregnancy or breastfeeding (unless approved by my physician)

I affirm that I have fully disclosed my medical history, medications, skincare use, and skin conditions to Pearl Peau and understand that failure to disclose relevant information releases the practitioner and facility from liability.

5. NO MEDICAL TREATMENT DISCLAIMER

I understand that this treatment is not a substitute for medical examination, diagnosis, or treatment. I acknowledge that the estheticians and practitioners at Pearl Peau are not qualified to diagnose, prescribe, or treat any physical or mental illness, and that nothing stated during consultation or treatment should be construed as medical advice.

6. PRE- AND POST-TREATMENT CARE RESPONSIBILITY

I agree to follow all pre- and post-treatment instructions provided by Pearl Peau, including but not limited to:

• Avoiding contraindicated skincare products or active ingredients as advised
• Using sunscreen and appropriate sun protection
• Avoiding excessive heat, steam, sweating, or friction for 24–48 hours if instructed

I understand that failure to follow aftercare instructions may negatively affect results and increase the risk of adverse reactions, for which Pearl Peau is not responsible.

7. ASSUMPTION OF RISK & RELEASE OF LIABILITY

I acknowledge that I have been fully informed of the nature of the Candela Glace™ Hydro-Dermabrasion treatment, its potential benefits, risks, side effects, and limitations. I understand that cosmetic procedures involve inherent risks, and I voluntarily assume all such risks.

I hereby release, indemnify, and hold harmless Pearl Peau, its owners, practitioners, employees, contractors, and affiliates from any and all claims, demands, damages, losses, or causes of action arising out of or related to this treatment, including but not limited to allergic reactions, skin irritation, adverse responses, or unsatisfactory results, except in cases of gross negligence or willful misconduct.

8. CONSENT & ACKNOWLEDGMENT

I certify that:

• I have read and fully understand this consent form
• I have had ample opportunity to ask questions, all of which have been answered to my satisfaction
• This document constitutes full disclosure and supersedes any prior verbal or written disclosures
• It is my voluntary decision to proceed with this treatment

I hereby give my informed consent to receive the Candela Glace™ Hydro-Dermabrasion treatment at Pearl Peau.