GENERAL CONSENT & LIABILITY WAIVER FOR AESTHETIC AND WELLNESS TREATMENTS AT THE REVIVE BAR

1. GENERAL CONSENT TO TREATMENT

I voluntarily consent to receive aesthetic, beauty, wellness, and body treatments provided by the above-named business and/or practitioner. I understand that treatments may include, but are not limited to:

• Vitamin injections/shots

• Microneedling

• Dermaplaning

• Facials

• Massage therapy

• Hot stone massage

• Red light therapy

• Korean brow lamination

• Korean lash treatments/lash lift

• Tinting services

• Facial waxing

• Body waxing

• Female intimate area waxing

I understand that results vary from person to person and no guarantees have been made regarding outcomes.

2. MEDICAL DISCLOSURE & CLIENT RESPONSIBILITY

I confirm that I have disclosed all relevant medical history, allergies, medications, skin conditions, injuries, pregnancy status, recent procedures, and health concerns that may affect my treatment.

I understand it is my responsibility to inform the practitioner if:

• I am pregnant or breastfeeding

• I have diabetes, epilepsy, autoimmune disorders, or circulatory issues

• I use Retin-A, Accutane, steroids, blood thinners, or active skincare acids

• I have allergies to latex, adhesives, wax, metals, skincare products, or topical ingredients

• I have recent sunburn, open wounds, infections, cold sores, rashes, or active acne

• I have had recent cosmetic procedures including Botox, fillers, chemical peels, or laser treatments

I understand withholding medical information may increase the risk of adverse reactions.

3. TREATMENT-SPECIFIC ACKNOWLEDGEMENTS

Vitamin Shots/Injections

I understand that vitamin injections may cause:

• Bruising

• Tenderness

• Swelling

• Dizziness

• Allergic reactions

• Infection at injection site

I confirm I have informed the practitioner of all medications, allergies, and medical conditions prior to treatment.

Microneedling

I understand microneedling may cause:

• Redness

• Irritation

• Peeling

• Sensitivity

• Temporary swelling

• Infection or pigmentation risks if aftercare is not followed

I agree to follow all aftercare instructions provided.

Dermaplaning

I understand dermaplaning involves exfoliation using a sterile blade and may result in:

• Mild redness

• Sensitivity

• Temporary irritation

• Breakouts

• Minor nicks or scratches

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Facials & Red Light Therapy

I understand facials and red light therapy may cause:

• Temporary redness

• Purging or breakouts

• Skin sensitivity

• Mild irritation

I understand red light therapy is not intended to diagnose, treat, cure, or prevent medical disease.

Massage & Hot Stone Massage

I understand massage treatments are for relaxation and wellness purposes only and are not medical treatment.

I acknowledge possible risks including:

• Muscle soreness

• Bruising

• Fatigue

• Burns or overheating risks associated with hot stones

I understand I may stop treatment at any time if uncomfortable.

Brow Lamination, Lash Treatments & Tinting

I understand these services involve chemical products near the eyes and skin and may cause:

• Irritation

• Allergic reactions

• Redness

• Eye sensitivity

• Over-processing if aftercare is not followed

I agree to complete a patch test where required and follow all aftercare instructions.

Facial, Body & Intimate Waxing

I understand waxing removes hair from the root and may cause:

• Redness

• Irritation

• Skin lifting

• Ingrown hairs

• Bruising

• Sensitivity

• Allergic reactions

  
  

For intimate waxing, I confirm:

• I am over 18 years old

• I understand the sensitive nature of the treatment

• I do not have active infections, cuts, or contraindications

  
  

4. AFTERCARE RESPONSIBILITY

I understand that following proper aftercare instructions is essential for minimising risks and achieving optimal results. Failure to follow aftercare guidance may increase the likelihood of complications.

5. LIABILITY RELEASE

I acknowledge that all treatments involve some degree of risk and possible side effects. I voluntarily assume all risks associated with the treatments listed above.

To the fullest extent permitted by law, I release and hold harmless the practitioner and business owner from liability for:

• Injury

• Allergic reactions

• Skin sensitivity

• Burns

• Bruising

• Dissatisfaction with results

• Complications resulting from withheld medical information or failure to follow aftercare instructions

except in cases of gross negligence or unlawful conduct.

6. PHOTO & MEDIA CONSENT

7. CANCELLATION & APPOINTMENT POLICY

I understand that missed appointments or cancellations without sufficient notice may result in fees or forfeiture of deposits according to clinic policy.

8. CLIENT CONFIRMATION

By signing below, I confirm that:

• I have read and understood this form

• I have had the opportunity to ask questions

• I consent voluntarily to the treatments selected

• The information I provided is accurate and complete