Patient Name: *

Date of Birth: *

Procedure Date: *

Introduction

A detox facial is designed to cleanse, hydrate, and rejuvenate the skin. This facial includes deep cleansing, exfoliation, mask application, and massage to promote healthy skin and eliminate toxins. It is intended to improve skin tone, reduce impurities, and promote a healthy glow.

Procedure

The procedure involves cleansing the skin, followed by the application of various products, including exfoliants, detox masks, and serums. The treatment is typically followed by a relaxing facial massage to stimulate circulation and promote skin health.

Potential Risks & Side Effects

I understand that, as with any facial treatment, there are possible risks, including but not limited to: *

Redness, swelling, or irritation of the skin

Breakouts or increased skin sensitivity

Allergic reactions to products used (rare but possible)

Dryness or tightness following the treatment

Temporary skin discoloration (in some cases)

Pre-Treatment Instructions *

Avoid sun exposure, tanning beds, or self-tanners for at least 24-48 hours before treatment.

Inform the practitioner of any allergies, skin conditions, or sensitivities.

Discontinue the use of any active skincare products, such as retinoids or exfoliating acids, prior to the facial.

Arrive with clean skin, free of makeup and heavy skincare products.

Post-Treatment Care

Post-Treatment Care *

Avoid touching or rubbing the treated area.

Apply moisturizer to keep the skin hydrated and prevent dryness.

Avoid excessive sun exposure, and use SPF 30+ sunscreen daily.

Follow any additional aftercare instructions provided by the practitioner.

Acknowledgment & Consent *

I confirm that I have read and understood the information provided regarding the detox facial. I have had the opportunity to ask questions, and I am aware of the possible risks and benefits of the procedure. I give my consent to proceed with the detox facial treatment.

Date: *

Patient Signature *

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Provider/Esthetician Name: *

Provider Signature *

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I agree to terms & conditions provided by the company.

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