Cancellation Policy 

To secure your appointment you will be asked to provide your credit/debit card number to put on a secure file. You card will have a hold for individual appointments. Deposit of 100$ flat fee for couples reservations is required, receive full refund if canceled 24 hours ahead. As therapists we are physically limited in the number of clients we can treat in a day. For that reason at least 24 hour cancellation notice in required to avoid a fee, you might be charged up to full cost for a no show or less than 1 hour prior cancellation since the therapist has reserved that time for only you in the schedule and we are unable to replace anyone the last minute. If you give us notice less than 24 hours prior but enough time to potentially rebook another client such as at least 12 hours, in that slot, you may be charged less than 100% or can receive a credit for future bookings.  If you no-show and do not notify us it will be 100% charge. If it’s a proven medical emergency such as sudden illness or contagious illness diagnosis you will receive credit for your next appointments if notice is less than one hour prior. New customers – please complete digital intake form we have sent you via email or text 1 day before your appointment time. Thank you.

Ways to save on your massage and skin care treatments

  • Due to VT Massage Therapy non-existing laws, we only bill insurance directly to some workers comp or other cases, but can assist you with providing required documentation or a super bill for any other reasons. You can also use your Flex spending cards or other similar Health Savings Account Cards provided by your work place.

Consent For Massage Services

Booking with Brilliant Massage Therapy, LLC I understand that the massage/bodywork I receive is provided for the basic purpose of relaxation and relief of muscular tension. If I experience any pain or discomfort during this session, I will immediately inform the practitioner so that the pressure and/or strokes may be adjusted to my level of comfort. I further understand that massage or bodywork should not be construed as a substitute for medical examination, diagnosis, or treatment and that I should see a physician, chiropractor, or other qualified medical specialist for any mental or physical ailment of which I am aware. I understand that massage/bodywork practitioners are not qualified to perform spinal or skeletal adjustments, diagnose, prescribe, or treat any physical or mental illness, and that nothing said in the course of the session given should be construed as such. Because massage/ bodywork should not be performed under certain medical conditions, I affirm that I have stated all my known medical conditions and answered all questions honestly. I agree to keep the practitioner updated as to any changes in my medical profile and understand that there shall be no liability on the practitioner’s part should I fail to do so. I also understand that any illicit or sexually suggestive remarks or advances made by me will result in immediate termination of the session, and I will be liable for payment of the scheduled appointment.

Consent For Esthetics Services

Booking an appointment at Brilliant Massage Therapy, LLC I agree to provide full disclosure and inform the esthetician if I experience any skin discomfort during a treatment, and that it supersedes any previous verbal or written disclosures. I understand that withholding information or providing misinformation to the esthetician may result in contraindications and/or irritation to the skin from treatments received. The treatments I receive here are voluntary and I release this institution and/or skin care professional from liability and assume full responsibility thereof. I am willing to follow recommendations made by my esthetician for a home care regimen that can minimize or eliminate possible negative reactions. In the event that I may have additional questions or concerns regarding my treatment or suggested home product / post-treatment care, I will consult the esthetician immediately. I have had sufficient opportunity for discussion to have any questions answered. 

Please note that peels and certain face products can cause peeling or temporary irritation, discomfort to certain individuals and is expected. I understand my esthetician will take every precaution to minimize or eliminate negative reactions as much as possible. 

Please note that waxing does have certain side effects such as skin removal, redness, swelling, tenderness, etc.

 

LAMPROBE INFORMED CONSENT FORM

Skin Care Consultants has explained to me the Lamprobe processes are popular and effective for the cosmetic treatment of unwanted hair follicles and certain minor superficial skin irregularities that professional skin care practitioners encounter on a daily basis.

I consent to have the Lamprobe performed or demonstrated on me and further consent to have the Practitioner elect one of the following skin irregularity or irregularities to be treated:

Telangiectasia                                                                                                                                           
Cholesterol                                                                                                                                                        
Milia                                                                                                                                                                                                      
Cherry Angioma                                                                                                                                          
Spider Naevi                                                                                                                                                    
Clogged Pores
Skin Tags
Fibromas
Acne Pimples
Other:___________

Risks associated with the Lamprobe may include, but are not limited to, burns/scabbing, blistering, skin discoloration, infection, and scarring. I understand that it is strongly advised and imperative that persons receiving cosmetic treatments using Lamprobe processes closely follow the Home Care Advice described below and further understand that failure to follow the below-described Home Care Advice may result in infection and scarring.  

By consenting to having the cosmetic treatments using Lamprobe performed or demonstrated on me, I hereby release and forever discharge the performing practitioner of said cosmetic treatment, Skin Care Consultants, its officers, employees, and/or associated sub-contractors, manufacturers, distributors and suppliers from all claims, demands, causes of action arising out of the performance of the said cosmetic treatment procedures excluding any claims for gross negligence or willful misconduct.  __________ ​​​​​​​​​​​  

Lamprobe regularly documents the demonstration and use of the Lamprobe, using before/after photos and/or videos.  I understand that this documentation will be the property of Lamprobe and may be used at a later date for educational and/or marketing purposes and I consent to this use.   __________ 

Home Care Advice:

After treatment with the Lamprobe, the areas cosmetically treated may feel irritated and redness and scabbing may form.

1. Do not directly touch treated area for 24-48 hours following treatment, as this can increase the risk of infection.

2.Do not pick at the scabs, as premature removal of scabs may result in hyper-pigmentation, infection, or scarring.

3. If the cosmetically treated area is still irritated in the evening, then apply antibiotic cream, e.g., Neosporin, or medicated powder to the area.  Keep the area dry for 24-48 hours following treatment.

4.  While cleansing the face or showering, use mild products without alcohol.  When appropriate, band aids should be applied to the treated area for further protection while showering or bathing.

5. After washing, pat the treated area dry. Do not rub the treat area as rubbing may result in the removal of the scab.

6. Do not apply make-up on the cosmetically treated area for 24 hours following treatment or until skin is healed.

7. Do not use any other form of peeling or bleaching products for at least 21 days following treatment.

8. Use of sun protection during the day, all year round, is recommended.  Avoid direct sunlight during the peak hours (11am-5pm).  

 

Teeth Whitening Consent Form:

 

INFORMED CUSTOMER CONSENT FOR TEETH WHITENING TREATMENT


I understand that I am participating in a professional teeth whitening procedure that is designed to lighten the color of my teeth. I understand that I will be allowed to use a specially designed LED Lamp in order to accelerate the whitening process.


RESULTS GUARANTEE


Although most natural teeth can benefit from a teeth whitening treatment, I understand that everyone’s teeth are different and that results will vary. I understand that people with yellowish teeth generally get the best results and that if my teeth have spots due to tetracycline use (grayish tint) or fluorosis, these will be difficult to whiten. Also, if I have artificial teeth, caps, crowns, veneers, porcelain, composite or other restorative materials, I shouldn’t expect dramatic results from this treatment because the peroxide gel will not whiten (or damage) artificial dental work. Also, I am aware that my teeth will never be whiter than the white color my genes naturally allow.


POTENTIAL RISKS


Although whitening treatments are generally safe, I understand that some of the potential complications of this treatment include, but are not limited to:

GUM/LIP IRRITATION: Whitening gel that comes in contact with gum tissue or the lips during the treatment may cause inflammation or whitening of these areas. This is due to inadvertent exposure of small areas of those tissues to the whitening gel. The inflammation and/or whitening of gums and lips is transient, and the color change of the gum tissue will reverse within 30 minutes. I may feel a stinging and tingling sensation on these soft tissues during the treatment if the gel comes in contact with them.


TOOTH SENSITIVITY:

Although uncommon, some customers can experience some tooth sensitivity during the first 24 hours after the whitening treatment. People with existing sensitivity, recently cracked teeth, micro-cracks, open cavities, leaking fillings, exposed roots, or other dental conditions that cause sensitivity may find that those conditions increase or prolong tooth sensitivity after the treatment.


SPOTS OR STREAKS:

Some customers may develop white spots or streaks on their teeth due to CALCIUM DEPOSITS that naturally occur in teeth. These spots are NOT caused by the peroxide gel. The gel just brings the already existing calcium deposits out and makes them visible again. These usually diminish over time.

RELAPSE:

After the treatment, it is natural for teeth color to regress somewhat over time. This is natural and should be very gradual, but it can be accelerated by exposing the teeth to various staining agents, such as coffee, tea, tobacco, red wine, colas, etc. I realize that I should not eat or drink anything except water during 60 minutes after the treatment because the gel opens the pores of my enamel and makes my teeth very vulnerable to staining agents. If I purchase a touch-up pen, I realize that my pores will remain open for as long as I use it so I should refrain from staining agents till I stop using the pen. Only 24 hours after I conclude the touch-up pen treatment can I resume my normal habits. I understand that the results of the treatment are not intended to be permanent and that secondary, repeat or touch-up treatments may be needed for me to maintain the color I desire for my teeth.


ELIGIBILITY



I understand that this treatment CANNOT be used by pregnant or lactating women, people under the age of 14, people with gum disease, open cavities, leaking fillings, or other dental conditions, or people with a known allergy to peroxide and/or to aloe vera. People that have had braces removed should wait 6 months for cement residue to wear off before getting a teeth whitening treatment and people with a piercing or other metal objects in the oral cavity should remove them before the treatment as they may turn black. If I feel a sharp pain on a particular tooth during the treatment I should stop the treatment and contact my dentist since this could be a sign of an open cavity.
By signing this document, I indicate that I am not ineligible as per the criteria listed above, that I have read and fully understand this entire document including the possible risks, complications and benefits that can result from the treatment, and that I am performing this treatment under my own responsibility. I also certify that

I HAVE HEALTHY TEETH AND GUMS.

Consent Form – Dental

P.S. All bills must be paid in full once the service is rendered or products are ordered for you. We not not offer pay later options. Thank you. 

Service costs and products are subject to price changes without advance notices and adjusted every year due inflation, based on demand and supply and to be able to continue to provide services at the same quality and convenience. If change of price does not meet your expectation you have the right to cancel the service. 

Online Store Return Policy On Products: 30 Days from the purchase date, in its original packaging and condition- full refund. We do not accept refunds on used products. Thank you.

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