• Facial Consent for COVID-19

    This patient disclosure seeks information that should be considered before making facial treatment in the circumstance of the COVID-19 virus.
  • Please disclose any indication of having been exposed to COVID-19, or whether you have experienced any signs or symptoms associated with the COVID-19 virus.

  • I fully understand and acknowledge the above information, risks and cautions regarding a compromised immune system and have disclosed to my provider any conditions in my health history which may result in a compromised immune system.
    By signing this document, I acknowledge that the answers I have provided above are true and accurate.

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