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At Aesthetics Forms we have a large selection of ready to use Aesthetics Form Templates. I understand that the clinical results and total numbers of treatments will vary between individuals depending on individual hormonal level, skin type, hair type, hair density, hair coarseness, age, genetics, medical conditions and other factors. There is no refund when you change to a lower priced package. Scarring - The Laser Hair Reduction system can burn or blister the skin which creates a risk of scarring. If you have had sun exposure, the technician will evaluate your skin, and may not be able to perform the treatment. Apply sunscreen daily. Sale ends in 16 hours. Send the form to other people via email, create a link for quicker document sharing, export the template to the cloud, or save it on your device in the current version or with Audit Trail included. Read all of it very closely. Not suitable for clients with Skin Type V to VI or tanned skin. Recommended treatment intervals: - Every 4 weeks for facial areas; - Every 6 weeks for body areas; - Every 8 weeks for the legs.
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Laser Hair Removal Consent Form Pdf Download
Our staff includes Nurse Practitioners, Registered Nurses and Aestheticians. I confirm that I have read the pre-treatment and post-treatment instructions provided by Bared Monkey MedSpa Inc. and all its affiliated companies and I understand that it's my responsibility to follow these instructions and that my failure to adhere to these recommendations may result in complications and contraindications for which I am fully responsible. We carried three different top of the line FDA cleared Laser Hair Removal equipments, ALMA Soprano, Candela Gentle Max Pro, Lumenis Splendor X, and we offer different types of laser wavelengths, Alexandrite Laser, ND-YAG laser and Diode Laser to help our clients to achieve the best results with safety and comfort level in mind. We apologize for any inconvenience this may cause. Improper post-treatment care may increase the chances of any complications. Most patients require a number of treatments over several months with gradual results occurring over this time. Avoid sun exposure 2 weeks after laser treatment. Folliculitis, which is an infection of the hair follicle, which may take several days to resolve. I have read and understand this agreement and all my questions have been addressed and answered to my satisfaction. Prescription Medications – Review prescription medications with your provider for potential sun sensitizing effects. Whether you work at a spa or doctor's office, this laser hair removal consent form makes it easy to gather the data and signatures you need before each session with your clients. Please save our text number (551)230-6569 /email address as point of contact***.
I understand it's my sole responsibility to inform my technician about any changes in my current medical conditions prior to any of my laser treatments. Consent Forms Laser Hair Removal Consent Form Laser Hair Removal Espanol Skin Tag, Mole, and Spot Removal Consent Form Lash Lift Consent Form Cellulite Treatment Consent Form IPL Consent Form Teeth Whitening Consent Form Micro needling Consent Form Lip Filler Botox Threads Fractional Laser. HISTORY: Have you ever had laser hair removal? If you have a history of herpes simplex virus in the treated area, we recommend preventative therapy with an oral anti-viral medication. Kybella® Consent Form. Should any type of skin infection occur, additional treatment including antibiotics might be necessary.
You may not be the best candidate for laser hair removal if any of the following contraindications pertain to: - Hormonal imbalance, PCOS, Hirsutism, pregnancy, menopause, and other endocrine conditions can affect the treatment outcome. Eliminating the need to scan or file paperwork frees up time for your staff to focus on clients. I will also notify Spa 35 of any changes in my health or medical care as they occur during my treatment program. Botox and filler injections are performed by medically trained injectors, not estheticians. Ultra sonic skin scrubber. Before and After Care Instructions. Laser hair removal has the ability to change someone's life in the long run, but the risks should always be considered before going into the procedure. Wait for Makeup Redness, flakiness, and crusting are all common after laser treatment. By using this site you agree to our use of cookies as described in our Privacy Notice. Make it easy for your clients to fill out this laser hair removal consent form at home, at the reception desk, or in the procedure room.
Laser Hair Removal Consent Form Pdf
Receive consent from your clients systematically using this Permanent Makeup Consent Form. Analgesics typically include but are not limited to benzocaine, lidocaine and tetracaine (BLT). Ultimately, seeking consent for laser hair removal is an important step, which ensures that the client understands the procedure and the potential risks involved with laser hair removal. Pacemaker, internal defibrillator, and any internal electrical devices.
I agree to follow these instructions carefully. Before receiving your Laser Hair Removal, CoolSculpting®, Microneedling, Botox®, Juvéderm® or Ultrasonic Treatment, you will be asked to complete treatment consent forms. Immune disorders such as Scleroderma, Lupus, Porphyria, Sarcoidosis, and others. It is important to know that laser hair reduction does not permanently remove hair, periodic touch up treatments may necessary.
This Patient Consent Form for Laser Hair Removal Mobile App facilitates the creation of a consent form for laser hair removal. Hyper-pigmentation (browning) and Hypo-pigmentation (whitening)- Both have been noted after treatment, especially with a darker complexion. Maintaining adherence to your schedule is critical for maximizing your laser hair reduction results. Customise with your logo and social media information.
Laser Hair Removal Consent Form Free
Looking for a facial or massage? Once optimum result is achieved, patients can return for a follow up 3 to 4 months later, or when there is around 15-20% of hair regrowth in the treatment area. I understand that this treatment is not meant to replace the necessity for a complete dermatological examination of suspicious lesions. The same rule applies to NO SHOW appointments. If your goals are best met through procedures than those offered in our Med Spa we can refer you to a surgeon.
This is a cosmetic treatment that could potentially conflict with other medically necessary medications used to treat disease. Allergic reactions- In rare cases, local allergies to tape, preservatives used in cosmetics or topical preparations, have been reported. Breastfeeding- Women who are currently breastfeeding cannot use any analgesic agents (typically used for numbing the area prior to treatment). Avoid photosensitive medications (i. Anti-biotic, Doxycycline, Tricyclic antidepressants, Quinidine, Amiodarone, St. ). © Copyright O'Réal Aesthetics LLC 2022 Privacy Policy | Terms of Service.
Avoid skin irritants (i. I understand that this procedure works on the growing hair follicles, not dormant hair. Laser or other treatments may not completely improve or prevent future skin disorders, lesions, or wrinkles. Center Representative's Signature.
The medical providers at Spa 35 Med Spa have been delivering cosmetic services for thirteen years. This site uses cookies to enhance site navigation and personalize your experience. Dark skin has a greater probability of burning than lighter skin. We are unable to treat clients that are on antibiotics, ACCUTANE, and PHOTOSENSITIZING medications. It is important to tell your provider about recent sun exposure and to report any use of light sensitizing drugs (such as Accutane) with an accurate medical history form. DO NOT SHAVE ON A DRY SKIN. Poorly controlled Diabetes. Monthly payment plans must be made on time, late monthly payments will result in cancelation of all upcoming appointments.
This app outlines the laser treatment procedure in detail, including risks involved. I certify that I have not taken Accutane within the past six months. The exchange must be done before your first treatment begins. Agree I do understand that TAXES and GRATUITY are not included.
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