If you are receiving Laser Hair Removal, we ask that you shave the day of the appointment. There is the possibility of complications, injury, and even death from all forms of analgesics. It is not to be used or relied on for medical, diagnostic, or treatment purposes. Bleeding- Pinpoint bleeding is rare but can occur following brown spot and spider vein treatment procedures. I've done them over lunch when I've gotten frustrated with a process that didn't exist in our company. Laser Hair Removal - Post Treatment Instructions. Laser Hair Removal Consent Form (Digital Download) –. The authority granted under this paragraph shall include all conditions that require treatment and are not known to the provider at the time the procedure is begun. Risks and Complications –. Photos from reviews. We look forward to meeting you on your initial visit to our offices. This app outlines the laser treatment procedure in detail, including risks involved. You may apply a cold compress if needed. I do understand that taxes and gratuities are NOT included in any service I purchase.
I will use sunscreen while tanning for the duration of my laser hair removal treatments. I. e. in between eyebrows and above). Have you used any of the following hair removal methods in the past four weeks IN THE AREAS THAT WILL BE LASERED? CHANGE OF TREATMENT AREA. Laser Hair Removal Procedure –. I agree that I will NOT ask the Technician to laser any area that has not been paid for, nor ask for any body part to be lasered that is not permitted by the Spa. Infection- Although infection following pulsed light treatment is unusual, bacterial, fungal, and viral infections can occur with scabbing or other disruption of the skin barrier function. All of my questions have been answered to my satisfaction and I consent to the terms of this agreement. Laser Hair Removal Consent Form. I also have completed an accurate medical history document and been informed about what I must do and "not do" before, during and after the series of treatments. If you have dark skin a skin lightening cream may be advised to reduce the melanin in your skin before the treatment. Choose One Always Burns, Never Tans Always Burns, Sometimes Tans Sometimes Burns, Always Tans Rarely Burns, Always Tans Brown, Moderately Pigmented Skin Black Skin.
Experience - Spa 35 Med Spa has been helping clients Look and Feel their Best for twelve years. No guarantee, warranty, or assurance has been made to me as to the results that may be obtained. Treatment over moles or lesion of any kind. If your teen is between 17 and 19, laser hair removal will be more effective than if your teen is 14. I understand that laser hair removal is not 100% permanent and is in fact a reduction of up to 90%. From the simple drag-and-drop form builder and automated email notifications to secure data storage and HIPAA compliance, Formstack's powerful tools will help you save resources, increase productivity, and improve the client experience. Laser hair removals is an elective, a voluntary cosmetic procedure. Laser hair removal consent form.fr. If your goals are best met through procedures than those offered in our Med Spa we can refer you to a surgeon. As a clinician, use this app to help document patient acknowledgement and consent of potential complications caused by laser hair removal like redness, discomfort, hypo pigmentation skin, and bruising. There are short term effects of laser hair reduction. It will address how the procedure works and explains possible risks and side effects. 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. I understand and agree that all services rendered to me are charged directly to me and that I am personally responsible for payment. Avoid exfoliating or peels for one week.
Delayed arrival will limit the time of your experience, reducing the effectiveness of your treatment and the expectations of your visit. Laser hair removal consent form sample. Use of Accutane (must discontinue use of product 6 months before beginning treatment). If there has been partial hair clearance, treatment should be continued between 6 to 8 weeks until optimum result (80-90% hair reduction) is achieved. Alternative options to Laser Hair Removal are waxing, plucking, shaving and electrolysis.
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. Patient Consent Form for Laser Hair Removal Form Mobile App - iPhone, iPad, Android. Treatment Interval and Follow Up Interval. Clients can enter their contact information, schedule appointments, read your terms and conditions, answer questions regarding their medical history, and provide their digital signature from any device. Customize your Salon Form to match your barbershop, hairdresser, or beauty shop with our easy-to-use Form Builder — no coding required! Showering- You may shower after the laser treatments and use a mild soap.
FOR OUR FEMALE CLIENTS: Are you pregnant or trying to become pregnant? Avoid very hot baths, showers, steam baths or saunas, and don't swim in strong chlorinated water for two or three days. There is no minimum age to start Laser, IPL or waxing treatments as long as there is hair growth in the first place. Usually, these side effects are rare, but it is important to be aware of the potential risks of the treatment. Systemic reactions (which are more serious) may result from prescription medicines.
It is common practice to tip after EACH treatment 15 - 20% of the original service price. Although the majority of patients do not experience these complications, you should understand the risks and potential complications. Got everything I needed and everything was as described. There is a risk that those agents can be found in breastmilk.
By not adhering to the post treatment skin care instructions you may increase the risk of any post procedure complications. Call Spa 35 with any questions or concerns regarding your treatment at 208-367-0700. Gratuities are accepted in the form of cash, venmo or zelle and go directly to the Technician that treated you. If you make a skin care consultation you can use this skin care consultation form to make an appointment for follow up check up. Use of photosensitive medications (i. e. Anti-biotic, Retinoids or other Acne medications, Antihistamines, Cancer chemotherapy drugs and other cancer drugs, Diabetic drugs, Statins, Malaria medications, Cardiac drugs, St. John Wort etc. ) Preparing the treatment area- For maximum results please prepare for your appointment with the treatment area shaved with 1-2 days of stubble. As with all LHR procedures, some re-growth of hair may occur after treatment sessions are completed. 7 Day Free Trial – No Card Details Required. Applying moisturizer after exfoliating will help skin replenish. Please save our text number (551)230-6569 /email address as point of contact***. Reason complete destruction of all hair follicles from any one treatment is unlikely and I understand that I will require multiple treatments at a regular scheduled interval to obtain significant long-term reduction of hair growth. Choose one of the services below to learn more about each treatment. You can also download it, export it or print it out. Which of the following best describes your skin type?
Results and patient experience may vary. Vein/IPL Consent Form. Do not exfoliate or use harsh soaps on the treated area for 48 hours after treatment. Please check all that apply). It is recommended to use new makeup to reduce the possibility of infection. DO NOT pick at these areas, as this may result in infection or scarring. Self-tanning lotions dramatically increase the risk of burns.
Medical Staff - The team is led by Nurse Practitioners and composed of Registered Nurses and aesthetic skin care professionals.