About
DERME PRO RX Assisted Online Aesthetic Protocol
Consent, Acknowledgement & Client Declaration
Please read this document carefully before your assisted online session. It explains how the protocol works, your responsibilities, and the limits of remote guidance.
Client Information
Details required before your session
Clients are required to share the following information so we can prepare and confirm the assisted protocol.
Purpose of this document
What this consent covers
This document records your acknowledgement and consent to participate in a Derme Pro Assisted Online Aesthetic Protocol.
The service provides remote guidance concerning the use of a specified Derme Pro product or treatment protocol. I understand that the service is conducted remotely and is therefore different from an in-person clinical examination or procedure.
Remote Assessment
I understand that the assisting professional may rely on:
- Information I provide;
- Photographs I submit;
- My stated skincare history;
- My stated medical or medication information;
- Information about previous procedures; and
- Other information available during the consultation.
I understand that photographs and remote communication cannot provide the same information as a physical examination. I confirm that the information I provide is accurate and complete to the best of my knowledge.
Scheduled Session
I understand that I will be given a specific date and time for my assisted protocol. I agree to:
- Attend at the scheduled time;
- Have the required product available;
- Have the necessary materials/equipment prepared;
- Follow the instructions provided before the session; and
- Remain available throughout the relevant assisted session.
Failure to attend or failure to adequately prepare may require rescheduling.
Protocol
I understand that Derme Pro will provide a specific protocol where appropriate. The protocol may include instructions concerning:
- Skin preparation;
- Product quantity;
- Application method;
- Treatment area;
- Exposure/contact time;
- Removal or neutralisation where applicable;
- Immediate aftercare;
- Post-treatment skincare;
- Sun protection;
- Product avoidance; and
- Follow-up care.
I agree to follow the protocol exactly as provided.
No Self-Modification
I agree not to independently:
- Increase the product concentration;
- Increase exposure time;
- Increase the amount applied;
- Repeat treatment earlier than instructed;
- Increase treatment frequency;
- Expand the treatment area;
- Combine the product with another clinical product;
- Introduce additional active ingredients;
- Substitute another product; or
- Create my own variation of the protocol.
I understand that modifying the protocol may increase the risk of adverse reactions.
Individual Response
I understand that every person's skin responds differently. I acknowledge that the outcome may be affected by factors including my skin type, skin condition, genetics, hormones, medication, skincare routine, environmental exposure, sun exposure, treatment compliance and aftercare.
I understand that Derme Pro does not guarantee a specific aesthetic result.
Possible Reactions
I understand that clinical skincare products and chemical peels may cause reactions including, depending on the product:
- Stinging;
- Redness;
- Dryness;
- Tightness;
- Flaking;
- Peeling;
- Sensitivity;
- Irritation;
- Temporary pigmentation changes;
- Allergic reaction; and
- Other adverse responses.
I understand that more serious reactions may occur in some circumstances. I agree to report significant or unexpected reactions to Derme Pro and to seek appropriate medical attention when necessary.
My Responsibility
I acknowledge that I am responsible for:
- Providing accurate information;
- Disclosing relevant conditions and medications;
- Following the protocol;
- Following aftercare;
- Using products correctly;
- Avoiding unauthorised combinations;
- Following sun-protection instructions;
- Reporting significant reactions; and
- Seeking appropriate medical care when necessary.
No Guarantee of Results
I understand and accept that the assisted online protocol is not a guarantee of a particular outcome. I understand that Derme Pro cannot guarantee:
- A specific aesthetic improvement;
- A specific amount of peeling;
- A specific degree of pigmentation reduction;
- A specific improvement in skin texture;
- A specific treatment duration; or
- Any other particular result.
Medical Care
I understand that this assisted online service does not replace an in-person examination by a dermatologist, doctor or other appropriately qualified healthcare professional.
If I experience severe pain, significant swelling, extensive blistering, difficulty breathing, severe allergic symptoms, serious eye exposure or another potentially serious reaction, I will seek appropriate medical attention immediately.
Limitation of Responsibility
I acknowledge that Derme Pro provides remote guidance based on the information available at the time of the session. I understand that Derme Pro cannot physically examine, touch, continuously monitor or control my skin during a home-use procedure.
To the maximum extent permitted by applicable law, Derme Pro will not be responsible for outcomes resulting from my failure to follow the provided protocol, inaccurate information provided by me, unauthorised modification of the protocol, use of other products, failure to follow aftercare or other factors outside Derme Pro's reasonable control.
Nothing in this acknowledgement is intended to exclude liability that cannot legally be excluded.
Photographs
Where photographs are requested for protocol assessment or follow-up, I confirm that the photographs I submit are of me and accurately represent my skin at the time submitted.
Where required, separate consent will be obtained before Derme Pro uses photographs for marketing, educational or promotional purposes.
Adverse Event Reporting
I understand that I may report a product-related concern through our contact channels.
Emergency Medical Care: I understand that Derme Pro's customer-support channels are not a substitute for emergency medical services.
Final Client Declaration
Please confirm the following before signing
By signing or electronically accepting this document, I confirm that:
Record of Acceptance
Sign and date below
This section is provided for reference. Acceptance is captured electronically at the point of purchase or registration.
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This record is provided for reference. Acceptance is captured electronically at the point of purchase.
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