Skin care treatment consent form

I understand this consent form and have answered each question truthfully. All of my questions have been answered to my satisfaction and I consent to the terms of this agreement. I do not hold the esthetician, whose signature appears below, responsible for any of my conditions that were present, but not disclosed at the time of this skin care procedure, which may be affected by the treatment performed today.

Our treatments may consist of surface cleansing, mild chemical peels or steam and exfoliation, application of antibacterial serums, corrective serums and extractions. These treatments are used as regimens for improving skin appearance and wellness. Mineral makeup may be applied the following day. Avoid strenuous exercise for two to three days after treatment. Avoid waxing, facials, botox, injectable fillers or any other skin care treatment two weeks after treatment.

If you make a skin care consultation you can use this skin care consultation form to make an appointment for follow up check up. 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. Protect your cells from environmental toxins and support damaged tissue repair. Treatments take approximately minutes to complete and are designed to balance, hydrate, clear acne impactions and prepare the skin for the home care regimen.

It is also recommended that the skin care therapist maintain a separate consent form for each treatment including, but not limited to: Laser, LED Light Therapy, Microcurrent, Chemical Peel, Vascutouch and Radio Frequency Treatments. You may ask the client to review and sign before a series of treatments. The main purpose of this form is to protect the patient. As a general rule, if the patient is of consenting age, no treatment or procedure should be performed without the patient’s consent.

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If you are concerned about potential complications, ask the client to sign a consent form each visit prior to treatment. The Medical History Form provides for full disclosure of pertinent client information that will enable the skin care therapist to develop a safe professional treatment plan as well as the home care treatment plan. This consent form provides information to assist in making an informed decision regarding Skin Care Treatments that include microdermabrasion, chemical peels, dermaplaning, needling, and the use of topical skin care products. FRAXEL TREATMENT CONSENT _____ Initial that you have read and understand this page. Once submitted securely, forms can be accesse viewed and downloaded when required.

Series of $1or Purchase a Series of $2Get the 7th treatment FREE! Member Associated Skin Care Professionals. Consent for Skin Care Treatments.

I am convinced my skin care products have an added boost to the overall appearance and feel of my skin necause of the ProCell Treatment System. Fort Worth, Texas ProCell Therapies offers cutting-edge biotechnology to induce a breathtaking transformation to the appearance of the skin that can last a lifetime. DISCUSSED THE TREATMENT PLAN WITH MY PHYSICIAN.

The Treatment you will receive is a clinical treatment designed to exfoliate or remove the outer layers of the skin. Your participation in your skin care treatments will determine the outcome. It is important that you strictly adhere to your home care products that your esthetician has recommended. Skin tightening procedures of any face or body area will probably scab up within 2-days. This consent provides us with your permission to perform reasonable and necessary medical examinations, testing and treatment.

I give my healthcare professional permission to use data about my treatment for research purposes. I consent to “before and after” photographs for the purpose of documentation, potential advertising and promotional purposes. It is the right of the patient to receive all the relevant information about his medical problem and ask as many questions about it as possible. Living Libations is a luxurious line of organic and pure renegade beauty products!

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