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The Obagi BLUE PEEL Patient Consent Form TO AID IN OPTIMAL RESULTS AND HEALING Do not over-moisturize keep skin dry. Avoid sun exposure and the use of sunscreens until healing has occurred- wear protective clothing a hat and sunglasses. Avoid the use of extreme facial expressions. DO NOT PICK RUB or FORCE OFF ANY SKIN* Avoid strenuous exercise and sweating. Do not allow water or shampoo to run on the treated areas while bathing or showering. Sleep on your back. DO NOT WEAR MAKEUP WHILE SKIN IS HEALING* To enhance the results of the Obagi BLUE PEEL after healing is complete resume treatment with the Obagi NU-DERM System* POTENTIAL RISKS AND COMPLICATIONS This procedure is one of the safest available for skin rejuvenations. However medical treatment is not an exact science and the degree of improvement is variable. Occasionally there is not improvement and another form of treatment may be required* Long-term complications resulting from the Obagi BLUE PEEL are rare. Due to the light nature of the peel complications usually seen in deeper peels laser or dermabrasion procedures such as keloids or scars are possible but are unlikely to occur. Infections due to bacterial contamination may occur if post-peel instructions are not followed* Temporary mild pigmentation problems may occur and can usually be corrected using the Obagi NU-DERM system* I hereby declare that I have read and fully understand the above. I understand the Obagi BLUE PEEL process and all its aspects. No guarantees were made to me regarding results and/or potential risks. All my questions were answered in a satisfactory manner and I consent Be-Lifestyle Medspa to perform the Obagi BLUE PEEL* Signature of Patient Date. Avoid sun exposure and the use of sunscreens until healing has occurred- wear protective clothing a hat and sunglasses. Avoid the use of extreme facial expressions. DO NOT PICK RUB or FORCE OFF ANY SKIN* Avoid strenuous exercise and sweating. Avoid the use of extreme facial expressions. DO NOT PICK RUB or FORCE OFF ANY SKIN* Avoid strenuous exercise and sweating. Do not allow water or shampoo to run on the treated areas while bathing or showering. Sleep on your back. Do not allow water or shampoo to run on the treated areas while bathing or showering. Sleep on your back. DO NOT WEAR MAKEUP WHILE SKIN IS HEALING* To enhance the results of the Obagi BLUE PEEL after healing is complete resume treatment with the Obagi NU-DERM System* POTENTIAL RISKS AND COMPLICATIONS This procedure is one of the safest available for skin rejuvenations. DO NOT WEAR MAKEUP WHILE SKIN IS HEALING* To enhance the results of the Obagi BLUE PEEL after healing is complete resume treatment with the Obagi NU-DERM System* POTENTIAL RISKS AND COMPLICATIONS This procedure is one of the safest available for skin rejuvenations. However medical treatment is not an exact science and the degree of improvement is variable. Occasionally there is not improvement and another form of treatment may be required* Long-term complications resulting from the Obagi BLUE PEEL are rare.

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