This will decrease the risk of a post treatment herpetic outbreak. On occasion there are people who do not respond to Laser Hair Reduction treatments. GoCanvas accounts come. 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.
Balances will automatically be charged to your account. Have you had any recent tanning or sun exposure in the last two weeks that changed the color of your skin? I certify that I have been fully informed of the nature and purpose of the procedure, expected outcomes, and possible complications. I understand the Inova Laser system is intended for hair removal and that clinical results may vary with different skin types, hair color, and body location. Laser hair removal Consent Forms Step 1 Step 2 Step 3 Laser Hair Removal Consent Form I understand that a $30. E-mail: Social Media. If your goals are best met through procedures than those offered in our Med Spa we can refer you to a surgeon. I have read and understand this agreement and all my questions have been addressed and answered to my satisfaction.
I understand that I cannot use acne topical creams, including Retinol and Chemical Acids. Avoid other laser treatments/ Microdermabrasion/ Chemical Peels/ Botox/ Filler on the treatment site. All medical and cosmetic procedures are associated with certain risks and may result in complications. Contraindications of Laser Hair Removal. Cryosurgery Consent Form. Spa 35 may provide you with additional or different information which is based on all the facts in your particular case and the state of medical knowledge. Please feel free to contact us if you have any questions. Please save our text number (551)230-6569 /email address as point of contact***. During LHR, the laser emits a light that is absorbed by the melanin in the hair and light energy is converted to heat which damages hair follies and inhibits or delays future hair growth. Cancer Diabetes High Blood Pressure Herpes Frequent Cold Sores HIV/AIDS Keloids Scarring Skin Disease/Skin Leisons Seizures Hepatitis Hormone Imbalances Other If Other, please list: Medications Are you taking oral medications presently? DO NOT pick at these areas, as this may result in infection or scarring. Not Good Candidates-. Laser Hair Reduction reduces hair growth using high energy light concentrated into the hair follicle. We continually adapt our practice and diverse services to reflect new and improved techniques and procedures.
One side effect of this is rampant hair growth. I certify that the preceding medical, personal and skin history statements are true and accurate. Laser hair removals is an elective, a voluntary cosmetic procedure. It is common practice to tip after EACH treatment 15 - 20% of the original service price. In a few treatments, typically six, you can dramatically decrease wasted time shaving and waxing. The same rule applies to NO SHOW appointments. Choose One Always Burns, Never Tans Always Burns, Sometimes Tans Sometimes Burns, Always Tans Rarely Burns, Always Tans Brown, Moderately Pigmented Skin Black Skin.
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. As laser hair removal involves strong lasers, there are some risks involved, especially with specific clients. Scheduled treatment may be postponed if the patient is tanned. We look forward to meeting you on your initial visit to our offices. Any internal metal device, i. surgical screws, pins, plates, or implants, in the area to be treated (no treatment if any device is superficially in the body area to be treated). Immune disorders such as Scleroderma, Lupus, Porphyria, Sarcoidosis, and others. 764 Madison Ave 3rd floorNew York, NY, 10065. 2, 260 reviews5 out of 5 stars. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. Before and After Care Instructions. Online forms make the client experience smoother and simpler, while improving your office's data management and security. Please be sure to read it before signing. Folliculitis, which is an infection of the hair follicle, which may take several days to resolve. Pigmented Lesion Consent Form.
This form will surely help the technician or clinic on how they will approach the client and offer the appropriate tient Registration Form Templates. All information is strictly confidential. You may apply deodorant after 24 hours. Digital downloads will be customised and emailed to you within 72 hours. With hundreds of form templates. Post treatment redness and discomfort. Current (active) skin cancer within one year or pre-malignant moles in the treatment area. I understand excessive sun exposure needs to be avoided two weeks before and two weeks after each treatment. A full 24 hours notice must be received before your appointment. Laser Hair Removal Informed Consent. If you have dark skin a skin lightening cream may be advised to reduce the melanin in your skin before the treatment. Others (Please list): Are you on any mood-altering or anti-depression medication?
You may apply a cold compress if needed. Like other skincare products, however, makeup can irritate your healing skin. As a courtesy, we will send email reminder/ text message to confirm your service appointments two business day prior to your appointment date.
DO NOT USE any other hair removal methods or products on the treated area during the course of your laser treatments, as it will prevent you from achieving your best results. © Copyright O'Réal Aesthetics LLC 2022 Privacy Policy | Terms of Service. In some cases, this can reactivate dormant hair follicles and induce new hair growth. Customise with your logo and social media information.