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Client Agreement Form
Client Agreement Form
I agree to contact my skincare professional so we can adjust your home care regimen at least every two weeks - We must adjust your home care routine every two weeks to keep your progress of clearing skin moving forward. If we don't change how you do your home care often enough, your skin will adapt to the regimen and stop responding (in other words, you won't get clear)*
I agree to check in every 2 weeks
I disagree
I agree to contact my skincare professional if my skin get uncomfortably dry and irritated - Each time we strengthen your home care, we run the risk of drying and irritating your skin, so you will need to communicate that to us if that happens.*
I agree to let you know if my skin gets irritated
I disagree
I will not use any other products, that have not approved by my skincare professional, while I am on the 90 day regimen*
I agree
I disagree
I will not change the regimen given to me by my skincare professional without notifying or consulting with them first*
I agree to not change the routine given to me
I disagree
I will not run out of product during the 90 day Program -When you stop using products (or run out) acne will start forming inside the pores and you will see it about a month later.*
I agree to not run out of products
I disagree
I will not have other skin care treatments during the 90 day program*
I agree to not do any treatments on my skin during the 90 day program
I disagree
I will inform my skincare professional of any medications/drugs that I start taking during the 90day program*
I agree to let you know about any medication changes
I disagree
I will use my sunscreen every morning, regardless of whether or not I will be going outside. The sunscreen will help to keep your skin moisturized. Without it, your skin will get too dry*
I agree to use my sunscreen every day
I disagree
I will not get sunburned or wind burned while being treated by my skincare professional. (you will not be able to use your active products)*
I agree to not get sun burned or wind burned
I disagree
I will inform my skincare professional if I elect to do any laser treatments or waxing for hair removal*
I agree
I disagree
Women: I will inform my skincare professional if I get pregnant
I agree
I disagree
I hereby agree to all of the above policies (type name)*
I will email photos of my face and other problem areas every 2 weeks*
I agree
Submit Client Agreement
×
Jean Kelly -Acne Esthetician
USA
630-254-2741
•
AcneClinic111@gmail.com
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