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HydraFacial Treatment Consent Form

HydraFacial is the only hydradermabrasion procedure that combines cleansing, exfoliation, extraction, hydration and antioxidant protection simultaneously, resulting in clearer, more beautiful skin with little-to-no downtime.
 

The treatment is soothing, moisturizing, non-invasive and generally non-irritating. As with most procedures, visible results from HydraFacial will vary from person to person.             

What to expect:

  • 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 immediately 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.  

Do you have any of the following?*

*Saying yes does not preclude you from receiving treatments.

Have you recently?

I acknowledge the following:

  • I will avoid the use of aggressive exfoliation, waxing, and products containing glycolic acids or retinols that are not part of the recommended take-home regimen in the treated areas for minimum 2 weeks pre-and post-treatment.  

  • Photos may be taken before, during and after the HydraFacial treatment. Photos will only be used with
    my written approval for education, promotion or advertising purposes.

  • The information provided has been explained to me and all my questions have been answered to my satisfaction. I have read the above information, and I give my consent to have the HydraFacial treatment by the staff at [Insert].

  • By signing below, I acknowledge that I have read the above information and give my consent to be treated with the HydraFacial System.

  • This consent form is valid for all future HydraFacial treatments. I will alert the staff If there are any future changes to my medical history.

Information submitted, thank you!

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