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Dermaplaning Consent Form
please fill the form below
Name:
First Name
Last Name
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We believes that our clients have the right to be informed of each treatment to makean informed decision to proceed with a treatment. Dermaplaning, as with many cosmetic proceduresdoes have risks, although they are very rare, they are a possibility.
I understand that Dermaplaning involves the use of a surgical blade to exfoliate the skin andremove fine vellus hair from the face.
I have been informed about the treatment and everything has been explained to my satisfaction.
I understand there is a risk of injury and I agree to assume those risks. These risks includeirritation, dryness and redness of the skin being treated.
I understand that the treatment may involve therisk of complication or injury and I freely assume those risks.Possible side effects of the treatment areacan include mild redness of the skin, irritation, and dryness.
Due to the use of a surgical blade in thistreatment, there is a possibility of small cuts to the skin being treated.
If a chemical peel, Eclipse MicroPen Microneedling or HydraFacial are part of this treatment: Iunderstand that the sensation and penetration of the secondary service will be enhanced.
This maycause skin irritation, mild discomfort, tenderness, lightening or darkening of the skin, infection, scarring,peeling, and activation of cold sores.
I certify that I have read this entire consent and that I understand and agree to the information provided inthis form. I certify that I am 18 years of age, or I have a parental consent co-signed below.
I will call to inform my esthetician of any complications or concerns as soon as they occur.
I certify that
I have read the above consent and I fully understand it and I herby consent to the Dermaplaning treatment.
I have read the above consent and I fully understand it and I herby consent to the Dermaplaning treatment.
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Patient Signature:
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