11550 Jonesbridge Rd, Suite# 6, Alpharetta GA 30022 Email: email@example.com Tel: (678) 829-7722 microdermabrasion Consent Form
Microdermabrasion uses a diamond encrusted wand to remove superficial layers of the skin in the treated areas. The intensity of the procedure can be adjusted to your desired results and comfort level. Microdermabrasion is often used to treat acne, reduce the appearance of scars, wrinkles, hyperpigmentation and other skin conditions. A series of treatments is recommended for maximum results. I confirm that I have none of the known conditions that could make treatment contraindicated, such as:
I understand immediately after treatment my skin may feel tight, warm and sensitive. Slight redness might appear and should resolve itself within a few hours. I understand a sunblock of at least SPF 30 is strongly encouraged to use daily. Tanning beds should be avoided for 1 week. Retinoids and facial scrubs should not be used for 24 hours following treatment. Use a mild cleanser. I understand no guarantee can be given as to final results, and several treatments may be needed to improve the skin condition. I certify that I have read and fully understand the above information, and that I have had sufficient opportunity for discussion. All my questions have been addressed and answered to my satisfaction.