Med Spa Chemical Peel Waiver
Liability Release, Assumption of Risk & Informed Consent
This agreement ("Agreement") is entered into between [Business Name], located at [Street Address], [City], [ST] ("Provider"), and the undersigned client ("Client") in connection with med spa chemical peel waiver services. By signing below, the Client acknowledges that they have read and understood each provision herein.
1. Acknowledged Risks Specific to This Procedure
The Client understands that the following risks are inherent to this specific service and cannot be eliminated even with proper technique and care:
- Temporary redness, stinging, and visible peeling of the skin
- Risk of post-inflammatory hyperpigmentation, especially in darker skin tones
- Possible scarring or infection if aftercare is not followed
- Reactivation of cold sores (herpes simplex) around the mouth
- Heightened sun sensitivity for weeks following treatment
2. Informed Consent to Chemical Exfoliation
The Client consents to the application of a chemical solution intended to exfoliate the outer layers of the skin. The Client understands that the depth of the peel, the concentration of acids used, and the number of treatments required are determined by the Provider based on skin assessment, and that outcomes such as the degree of peeling and redness cannot be precisely predicted.
3. Specific Risks of Chemical Peels
The Client acknowledges that chemical peels may cause temporary stinging, redness, flaking, and swelling, and in less common cases prolonged hyperpigmentation or hypopigmentation, scarring, infection, or cold-sore reactivation. Clients with darker skin tones, recent sun exposure, or a history of keloids face elevated risk and have disclosed such factors to the Provider.
4. Assumption of Risk
The Client voluntarily elects to receive the services described in this Agreement with full knowledge of the inherent risks involved. The Client understands that no procedure is entirely without risk and that individual results, reactions, and tolerances vary. The Client knowingly and freely assumes all such risks, both known and unknown, even if arising from the negligence of the Provider, and assumes full responsibility for participation.
5. Release and Waiver of Liability
In consideration of being permitted to receive the services, the Client hereby releases, waives, discharges, and covenants not to sue the Provider, its owners, employees, and agents from any and all liability, claims, demands, or causes of action arising out of or related to any loss, damage, or injury that may be sustained while receiving the services, to the fullest extent permitted by law.
6. Medical History and Disclosure
The Client affirms that they have disclosed to the Provider all relevant medical conditions, allergies, medications, and prior adverse reactions. The Client understands that withholding such information may result in injury for which the Provider bears no responsibility, and agrees to promptly notify the Provider of any change to their health status prior to receiving services.
7. Post-Peel Aftercare Obligations
The Client agrees to follow all aftercare instructions, including strict sun avoidance, daily broad-spectrum SPF, refraining from picking or peeling the treated skin, and avoiding retinoids and exfoliants until cleared by the Provider. Failure to follow aftercare may compromise results and increase the risk of complications.
8. Indemnification and Hold Harmless
The Client agrees to indemnify, defend, and hold harmless the Provider from any loss, liability, damage, or cost, including reasonable attorneys' fees, that the Provider may incur as the result of the Client's receipt of services, whether caused by the negligence of the Client or otherwise.
9. Governing Law and Venue
This Agreement shall be governed by and construed in accordance with the laws of the state in which the Provider operates, without regard to its conflict-of-law principles. Any dispute arising under this Agreement shall be brought exclusively in the state or federal courts located in that state.
10. Photography and Media Release
The Client grants the Provider permission to capture before-and-after photographs for the purposes of clinical records and, where separately initialed, marketing. The Client may withdraw marketing consent at any time in writing without affecting the validity of this Agreement.
11. Data Privacy and Communications
The Client consents to the Provider collecting and storing the personal information provided herein for the purposes of service delivery, scheduling, and follow-up care. Information will not be sold to third parties. The Client may request access to or deletion of their records consistent with applicable law.
12. Severability and Entire Agreement
If any provision of this Agreement is held to be invalid or unenforceable, the remaining provisions shall continue in full force and effect. This document constitutes the entire agreement between the parties regarding its subject matter and supersedes all prior understandings, whether written or oral.
The Client affirms they are at least 18 years of age (or the parent/legal guardian of a minor participant), have had the opportunity to ask questions, and sign this release freely.
Client signature, printed name and date, and (for a minor) the parent or guardian's signature.