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Dermaplaning Release Form

Let us do this part
Today's Date:
Thu Jul 17 2025 06:27
Practitioner:*
******IMPORTANT COVID INFORMATION*****

You MUST attend your appointment alone. No friends or family permitted, including children.

PLEASE COME TO YOUR APPOINTMENT ON TIME AND WAIT OUTSIDE TO BE CALLED IN. If you are early you will not be able to wait inside.
Clean face coverings MUST be worn at all times. If you forget yours we can supply for a small fee.
Please make a point of reading all signage on arrival for your safety.
If you experience any symptoms prior to your appointment, PLEASE contact us to reschedule.

I fully comprehend that Dermaplaning involves the use of surgical blades to disengage vellus hair and dead skin cells. I understand that as with any use of sharp blades, there is a small risk of grazing or cutting. I fully understand that whilst every possible risk averse strategy has been employed, including all practical precautions, the risk is still there.

I fully understand the procedure of Dermaplaning. I know fully well that there are contraindications to Dermaplaning including but not limited to bleeding disorders, cancer, diabetes and acne which is active. Medications which are contraindicated include high level aspirin, blood thinners and Accutane, all of which must not be used with this treatment as they delay clotting. If a graze was to occur, it could be very serious.

I confirm that I have not had any aggressive facial services such as waxing or microdermabrasion in the last 2 weeks, and if I have I have let Hayley know on booking.

I confirm and certify that I am not in receipt of any of the above medications or using any without prescription.
Please read and answer
I agree to all of the statements above*
I agree
I give my consent for Dermaplaning to be performed by Hayley*
I agree
If you have anything to declare or have any questions before your appointment, please contact us through our Facebook messaging service.
If any provision, section, subsection, clause or phrase of this release is found to be unenforceable or invalid, that portion shall be severed from this contract. The remainder of this contract will then be construed as though the unenforceable portion had never been contained in this document.
Client Information
I hereby declare that I am of legal age (with valid proof of age) and am competent to sign this Agreement.
Name:*
Address:
Postcode:
Date of birth:*
You must be 18 or older
Phone #:*
Email:*
Signature:*


Photo ID
Please take photo(s) of your government issued photo IDs and related paperwork.