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Consent & Treatment Waiver

Your safety and satisfaction are our priorities at Saray Aesthetics. Please review the following medical disclosure and consent agreement. Completing this form ensures that your aesthetic specialist has all the necessary clinical information to curate a safe and effective treatment path tailored to your unique skin profile.

Information Required

The form below captures clinical details: Full Name, DOB, Contact Preferences, Emergency Contacts, Health Conditions, Allergies, Topical Regimens, Pregnancy Status, Previous Skin Procedures, and Aesthetic Goals.

By submitting this intake form, I certify that I have been informed of the potential risks and aftercare protocols. I consent to treatment and acknowledge that clinical photography is required for record-keeping.

Clinical Consent Form

Please provide your details and medical history for your treatment at Saray Aesthetics.

Date of Birth
Month
Day
Year
Are you currently pregnant or breastfeeding?
Yes
No
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