I will read, comprehend and complete this questionnaire truthfully. I agree that this constitutes full disclosure, and that it supersedes any previous verbal or written disclosures. I understand that withholding information or providing misinformation may result in contraindications and/or irritation to the skin from product(s)/service(s) I may receive. The service(s) I receive are voluntary and I release Ashanti Rose Pro Beauty LLC and its staff from liability and assume full responsibility thereof.