Dunwoody Wellness Center

Concent Form

We are delighted that you have selected Dunwoody Wellness Center and hope you enjoy your experience with us.  You are our priority; please do not hesitate to speak with our staff regarding your personal needs and expectations. Thank you.

Guest Responsibility

It is the guest’s responsibility to tell your provider ao any pre-existing medical conditions or medications presently and anticipated to be taken. It is also important that the provider be informed about any skin sensitivities, allergies, or known reactions to services and products in the past. To better tailor your treatment, please also inform your provider of any lifestyle changes past, present, or future.

We do not recommend certain Esthetic services for those who are taking or have recently taken medication which thins or exfoliates the skin, such as Accutane, Retin-A or any medication in this family.

I am aware that certain medications, over the counter products, or medical conditions can significantly increase the risk of injury when combined with certain services.

I understand that I should consult with my physician prior to receiving services if I have a medical condition or use medication on a regular basis.

I understand that certain procedures require follow-up visits to ensure the effectiveness and safety of these procedures. And that discontiuation of these procedures may results in injury.

I understand that there are risks associated with services provided at Dunwoody Wellness Center, and I agree that as a condition of receiving these services one-time or on an ongoing basis, I will assume all risks and relieve Dunwoody Wellness Center, including employees, agents, representatives, share holders, and officers from all liability arising wholly or partly from negligence, and release and discharge them from any and all claims, demands or actions involving such injuries or complications that may arise from these services or from use of the facilities.