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Please note, you must fill out this form before our appointment.

Your skin may experience temporary irritation, tightness, or redness. These are all normal reactions that typically resolve within 72 hours depending on skin sensitivity. You may experience tingling and stinging in the treatment area. These sensations generally subside within a few hours. Client experiences may vary. Some clients may experience a delayed onset of these symptoms.  You will likely see results after 5 days after treatment and your skin may feel smooth and hydrated for one to four weeks with appropriate home care to maintain treatment results. The skin is more susceptible to sunburn/sun damage. Avoid excessive sun exposure and use a minimum of SPF 40 sunscreen. I will avoid the use of aggressive exfoliation, waxing, and products containing glycolic acids or retinol that are not part of the recommended take-home regimen in the treated areas for a minimum 2 weeks pre-and post-treatment. 

All deposits and booking fees are non-refundable unless agreed to with the practitioner.

Do you understand the information you have been provided?
Do you have any medical conditions?
Are you pregnant or breastfeeding?
Do you have a neuromuscular disease (e.g. MS, ALS, motor neuropathy myasthenia gravis, or Lambert-Eaton syndrome)?
Do you have an autoimmune disease?
Are you taking antibiotics or other prescription medications?
Do you have any skin conditions?
Do you have any known allergies or have ever had anaphylaxis?
Do you have any active infection at the intended site of procedure?
Is there any other Medical and/or Social History that we should know? If so, please provide full detail below.
Have you had this or a similar treatment before? If so, did you experience any problems? Please provide full details below.
Do you have any concerns? If so, please provide full details below.
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