Please take a moment to read the information below. Please choose colour choice from drop down. 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. Considering that I have been informed that certain medical conditions and medications prohibit the patient from laser therapy, I have provided a full and truthful medical history and a truthful and accurate account of my medications to this office. Yes No I certify that the medical, personal and skin history statements I have provided are true and correct. Please Contact Us with Any Questions. Yes No Have you performed any of the following hair removal methods in the past six weeks?
There are several alternatives to laser hair removal treatment including electrolysis, shaving, waxing and tweezing. I fully understand and I am aware that if I am taking any medication(s)/antibiotics that cause photosensitivity, I will be exposing myself to the risk of getting scarred or burned while undergoing my laser hair removal treatments. Genetics, hormones, and hair color may interfere with hair reduction and some people may not respond at all. You must call your doctor immediately if any complications develop post procedure. Jolene Nails COVID 19 Liability Release Waiver. History of melanoma, active or inactive anywhere on the body. Download the Laser Hair Removal Consent Form that is designed to assist a Laser hair removal procedure. Skin disorder such as keloids or abnormal wound healing. Editable General Liability Waiver, New Client Form Spa, Esthetician Business Planner. By checking here, you are waiving that right. Avoid moisturizers with alpha-hydroxy acids. 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.
We will only exchange the value of the treatment price/package purchased towards another treatment. This eliminate the time consuming process of meeting with your client just to acquire their consent or even save time from the tedious but necessary process of getting consent by letting them fill up this form in their convenience. Laser Hair Removal Informed Consent. Kybella® Consent Form. Possible risks and complications associated with laser hair removal procedure include: - Temporary reddening, burning, swelling, bruising or discoloration of the skin over the treated area.
The Diode Laser (810nm) laser is more effective for Terminal Hair (longer, coarser and darker hair). Sun exposure, tanning beds or the use of self tanning products could result in a less effective treatment. Results and patient experience may vary. Burned skin - The light energy from a Laser Hair Reduction treatment can burn your skin, in some cases severely. Laser Hair Removal - Synergistic Treatments. There is no minimum age to start Laser, IPL or waxing treatments as long as there is hair growth in the first place. Please understand that it is your responsibility to text or email us when you need to modify your appointment to avoid the cancellation fee. To get started, simply select a template below that best suits your needs, customize it to match your needs and branding, and embed it in your website or send it to clients directly to gather their consent online. This usually resolves within weeks but can take as long as 3-6 months. Radiesse Consent Form. Why Chose Spa 35 Med Spa for Your Cosmetic Treatments? Blue Skin Laser Spa does not discriminate against people who have any physical, intellectual, or sensory disability. This site uses cookies to enhance site navigation and personalize your experience.
Patient Consent Form for Laser Hair Removal. If your teen is between 17 and 19, laser hair removal will be more effective than if your teen is 14. Photographs on this website are used to illustrate how services are used and their potential impact on your appearance. Juvederm/Volbella/Voluma Consent Form. This facial consultation form template provides to collect contact information, skin information such as skin care goals, skin care challenges, skin care products that are used by the client, health information such as illnesses, allergies. Therefore, you can be as young as 14 and qualify for the treatment. As laser hair removal involves strong lasers, there are some risks involved, especially with specific clients. You may apply a cold compress if needed. I understand that grey, blonde, red hair cannot be treated with the laser. 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?
Insert and customize text, images, and fillable areas, whiteout unneeded details, highlight the important ones, and comment on your updates. Use this app to inform clients of the healing process, along with any complications or applicable short-term effects associated with laser skin treatment. Address: 3021 Piedmont Road, NE. Post Procedure Instructions –. Gratuities are accepted in the form of cash, venmo or zelle and go directly to the Technician that treated you. Choose your city below to fill out the consent forms. Fail to shave will be subject to rescheduling or a shaving fee.
Whether you need client intake forms, consent forms, or appointment forms for your spa or salon, treat yourself to our selection of online salon form templates to help you take care of business. Self-Tanner- Stop the application of self-tanner for four weeks prior to treatment. I recognize that during the course of the treatment, medical treatment or anesthesia, unforeseen conditions may necessitate different procedures than those above. Vein/IPL Consent Form. Avoid exfoliating or peels for one week.
I therefore authorize Spa 35 providers to perform such other procedures that are in the exercise of his or her professional judgment necessary and desirable. Others (Please list): Are you on any mood-altering or anti-depression medication? Draw your signature, type it, upload its image, or use your mobile device as a signature pad. Online forms make the client experience smoother and simpler, while improving your office's data management and security.
You may apply deodorant after 24 hours. Birth Control Pills Hormones None. Customize your Salon Form to match your barbershop, hairdresser, or beauty shop with our easy-to-use Form Builder — no coding required! It is very important that you comply with all post procedure instructions. It's gentle to treat all skin types.
Please click on the links below to fill out the respective forms you will need for your visit. Type text, add images, blackout confidential details, add comments, highlights and more. I do understand that if I fail to shave the night before my appointment, I will NOT be treated, and same day rescheduling fees apply. Limit to selective treatment areas (XL areas will be excluded from any promotional package) if the desired treatment area is not on the "AREA SELECTIONS LIST", client can exchange or upgrade the package in the store. Avoid very hot baths, showers, steam baths or saunas, and don't swim in strong chlorinated water for two or three days.
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