{"id":6596,"date":"2025-03-29T07:35:34","date_gmt":"2025-03-29T07:35:34","guid":{"rendered":"https:\/\/clinic.weecode4u.com\/?page_id=6596"},"modified":"2025-03-29T07:36:18","modified_gmt":"2025-03-29T07:36:18","slug":"peels-client-informed-consent-form","status":"publish","type":"page","link":"https:\/\/allurebeautyandaesthetics.com.au\/murray_bridge\/peels-client-informed-consent-form\/","title":{"rendered":"Peels Client Informed Consent Form"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"6596\" class=\"elementor elementor-6596\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-c19a3b2 e-flex e-con-boxed e-con e-parent\" data-id=\"c19a3b2\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-140ab64 elementor-widget elementor-widget-text-editor\" data-id=\"140ab64\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"ff-el-group  ff-custom_html\" data-name=\"custom_html-6_1\"><h2>Peels Client Informed Consent Form<\/h2>\n<p>To the CLIENT: You have a right to be informed about your condition and its treatment, so that you may decide whether or not to undergo the procedure after knowing the risks and hazards involved.&nbsp;&nbsp; This disclosure is not meant to scare or alarm you; it is simply an effort to make you better informed so you may give, or withhold, your consent for treatment.<\/p>\n<p><strong>I voluntarily request the Allure Beauty &amp; Aesthetics to perform the peel procedure. I acknowledge having been informed that this cosmetic procedure is intended to remove surface layers of the skin to improve the vitality of the skin.<\/strong><\/p>\n<ol>\n<li>Peels, despite their high levels of efficacy and safety, are not free of side effects. Erythema (redness) and edema (swelling) of the treated area can occur but usually subsides within a few hours but can last up to seven days or longer.&nbsp; Irritation, itching, and\/or mild burning sensation or pain similar to sunburn may occur within 48 hours of treatment.<\/li>\n<li>It is important to use sunscreen of SPF 30 or greater when exposed to the sun.<\/li>\n<li>I understand complications can include white heads, cold sores, infection, scarring, numbness, and permanent discoloration, particularly in people with dark skin.<\/li>\n<li>No guarantee, warranty, or assurance has been made to me as to the results that may be obtained. I am aware that follow-up treatments may be necessary for desired results. Most patients require a number of&nbsp; treatments over&nbsp; several&nbsp; months with&nbsp; gradual results occurring over&nbsp; this time. Clinical results will vary per patient.&nbsp; I agree to adhere to all safety precautions and regulations during the treatment. No refunds will be given for treatments received.<\/li>\n<li>I have read and understand the Pre and Post-Treatment Instructions. I agree to follow these instructions carefully.<\/li>\n<\/ol>\n<p>I understand and agree that all services rendered to me are charged to me directly and that I am personally responsible for payment. The nature and purpose of the treatment have been explained to me.&nbsp;&nbsp; I have read and understand this agreement.&nbsp; All my questions have been answered to my satisfaction and I consent to the terms of this agreement. Alternative methods of treatment and their risks and benefits have been explained to me and I understand that I have the right to refuse treatment.<\/p><\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-9ac3877 elementor-widget elementor-widget-wpforms\" data-id=\"9ac3877\" data-element_type=\"widget\" data-widget_type=\"wpforms.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<style id=\"wpforms-css-vars-elementor-widget-9ac3877\">\n\t\t\t\t.elementor-widget-wpforms.elementor-element-9ac3877 {\n\t\t\t\t--wpforms-field-size-input-height: 43px;\n--wpforms-field-size-input-spacing: 15px;\n--wpforms-field-size-font-size: 16px;\n--wpforms-field-size-line-height: 19px;\n--wpforms-field-size-padding-h: 14px;\n--wpforms-field-size-checkbox-size: 16px;\n--wpforms-field-size-sublabel-spacing: 5px;\n--wpforms-field-size-icon-size: 1;\n--wpforms-label-size-font-size: 16px;\n--wpforms-label-size-line-height: 19px;\n--wpforms-label-size-sublabel-font-size: 14px;\n--wpforms-label-size-sublabel-line-height: 17px;\n--wpforms-button-size-font-size: 17px;\n--wpforms-button-size-height: 41px;\n--wpforms-button-size-padding-h: 15px;\n--wpforms-button-size-margin-top: 10px;\n\n\t\t\t}\n\t\t\t<\/style><div class=\"wpforms-container wpforms-container-full wpforms-render-modern\" id=\"wpforms-6588\"><form id=\"wpforms-form-6588\" class=\"wpforms-validate wpforms-form wpforms-ajax-form\" data-formid=\"6588\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/murray_bridge\/wp-json\/wp\/v2\/pages\/6596\" data-token=\"57f4c69c0487484d2547891af2eafda4\" data-token-time=\"1776407274\"><noscript class=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/noscript><div class=\"wpforms-hidden\" id=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/div><div class=\"wpforms-field-container\"><div id=\"wpforms-6588-field_1-container\" class=\"wpforms-field wpforms-field-layout\" data-field-id=\"1\"><div class=\"wpforms-field-layout-rows wpforms-field-large\"><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-33\"><div id=\"wpforms-6588-field_2-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"2\"><label class=\"wpforms-field-label\" for=\"wpforms-6588-field_2\">Patient Signature<\/label><input type=\"text\" id=\"wpforms-6588-field_2\" class=\"wpforms-field-medium\" name=\"wpforms[fields][2]\" aria-errormessage=\"wpforms-6588-field_2-error\" ><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-33\"><div id=\"wpforms-6588-field_3-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"3\"><label class=\"wpforms-field-label\" for=\"wpforms-6588-field_3\">Patient Name<\/label><input type=\"text\" id=\"wpforms-6588-field_3\" class=\"wpforms-field-medium\" name=\"wpforms[fields][3]\" aria-errormessage=\"wpforms-6588-field_3-error\" ><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-33\"><div id=\"wpforms-6588-field_4-container\" class=\"wpforms-field wpforms-field-date-time\" data-field-id=\"4\"><label class=\"wpforms-field-label\" for=\"wpforms-6588-field_4\">Date<\/label><div class=\"wpforms-datepicker-wrap\"><input type=\"text\" id=\"wpforms-6588-field_4\" class=\"wpforms-field-date-time-date wpforms-datepicker wpforms-field-medium\" data-date-format=\"m\/d\/Y\" data-disable-past-dates=\"0\" data-input=\"true\" name=\"wpforms[fields][4][date]\" aria-errormessage=\"wpforms-6588-field_4-error\" ><a title=\"Clear Date\" data-clear class=\"wpforms-datepicker-clear\" style=\"display:none;\"><\/a><\/div><\/div><\/div><\/div><\/div><\/div><\/div><!-- .wpforms-field-container --><div class=\"wpforms-submit-container\" ><input type=\"hidden\" name=\"wpforms[id]\" value=\"6588\"><input type=\"hidden\" name=\"page_title\" value=\"\"><input type=\"hidden\" name=\"page_url\" value=\"https:\/\/allurebeautyandaesthetics.com.au\/murray_bridge\/wp-json\/wp\/v2\/pages\/6596\"><input type=\"hidden\" name=\"url_referer\" value=\"\"><button type=\"submit\" name=\"wpforms[submit]\" id=\"wpforms-submit-6588\" class=\"wpforms-submit\" data-alt-text=\"Sending...\" data-submit-text=\"Submit\" aria-live=\"assertive\" value=\"wpforms-submit\">Submit<\/button><img decoding=\"async\" src=\"https:\/\/allurebeautyandaesthetics.com.au\/murray_bridge\/wp-content\/plugins\/wpforms\/assets\/images\/submit-spin.svg\" class=\"wpforms-submit-spinner\" style=\"display: none;\" width=\"26\" height=\"26\" alt=\"Loading\"><\/div><\/form><\/div>  <!-- .wpforms-container -->\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Peels Client Informed Consent Form To the CLIENT: You have a right to be informed about your condition and its treatment, so that you may decide whether or not to undergo the procedure after knowing the risks and hazards involved.&nbsp;&nbsp; This disclosure is not meant to scare or alarm you; it is simply an effort&#8230;<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-6596","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/allurebeautyandaesthetics.com.au\/murray_bridge\/wp-json\/wp\/v2\/pages\/6596","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/allurebeautyandaesthetics.com.au\/murray_bridge\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/allurebeautyandaesthetics.com.au\/murray_bridge\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/allurebeautyandaesthetics.com.au\/murray_bridge\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/allurebeautyandaesthetics.com.au\/murray_bridge\/wp-json\/wp\/v2\/comments?post=6596"}],"version-history":[{"count":4,"href":"https:\/\/allurebeautyandaesthetics.com.au\/murray_bridge\/wp-json\/wp\/v2\/pages\/6596\/revisions"}],"predecessor-version":[{"id":6600,"href":"https:\/\/allurebeautyandaesthetics.com.au\/murray_bridge\/wp-json\/wp\/v2\/pages\/6596\/revisions\/6600"}],"wp:attachment":[{"href":"https:\/\/allurebeautyandaesthetics.com.au\/murray_bridge\/wp-json\/wp\/v2\/media?parent=6596"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}