In response to the COVID-19 pandemic; we are committed to taking extra precautions. This health screening is to ensure your understanding of health and wellness as it relates to sanitation and disinfecting practices. As recommended by the CDC all service providers at Beauty Regime will continue to record body temperatures daily and will stay home and/or reschedule your appointment if we fall ill or are showing any of the signs/symptoms listed below. Please complete the following COVID-19 health screening.
Common symptoms of Covid-19 may include, but not limited to:
Cough or dry cough
Shortness of breath or difficulty breathing
Fever or chills
Muscle or body aches/pain
New loss of taste or smell
Congestion or runny nose
Nausea or vomiting
COVID-19 is a highly contagious virus that spreads from person to person. In addition to long-held and explicit sanitation measures, this business has always adhered to, new preventative measures have been put in place to further reduce the spread of this novel coronavirus. However, these best practices still offer no guarantee regarding your potential risk of being infected.
Consent for Treatment
I understand that, because esthetics involves maintained touch and close physical proximity over an extended period of time, there may be an elevated risk of disease transmission, including COVID-19. By signing this form, I acknowledge that I am aware of the risks involved from receiving treatment at this time, I voluntarily agree to assume those risks, and I release and hold harmless the practitioner/business from any claims related thereto. I give my consent to receive treatment from this practitioner
Your COVID-19 Health Screening Form submission was successful!
Please complete the Informed Consent For Treatment form below.
Please complete and submit this form to be prompted to schedule your service.
PRECAUTIONS (Please read carefully):
Your participation in your skincare treatments will determine the outcome. It is important that you strictly adhere to your home care regimen that your aesthetician has recommended.
No guarantee is expressed or implied as to the precise results, peeling times, or discomfort.
During the treatment, you may experience some tightening of the skin, which may last for several days.
For most patients, flaking begins within 48 hours. It is impossible to pre-determine how much peeling will occur. The shedding process usually subsides within 5-7 days.
Depending on the treatment performed and your skin quality, the following reactions may occur in some patients:
Prolonged redness, irritation & flakiness
Dryness & sensitivity
Severe allergic reactions in rare instances
Thank you for submitting your form!