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HydraFacial™ Keravive ™
Treatment Consent Form

HydraFacial Keravive is a unique, relaxing treatment designed to cleanse, stimulate, nourish, and hydrate the scalp for fuller and healthier−looking hair. As with most procedures, visible results from HydraFacial Keravive will vary from person to person.

 

What to expect

• Your scalp may experience temporary irritation, tightness, or redness. These are all normal reactions that typically resolve within 72 hours depending on scalp 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 symptoms.

• The combination of in−office cleansing, exfoliation and hydration, and daily use of the take−home spray improves circulation and nourishes the hair follicles for thicker, shinier, healthier−looking hair.

• The scalp can be susceptible to sunburn/sun damage. Avoid excessive sun exposure and use a minimum of SPF 30 sunscreen.

• It is recommended to have the HydraFacial Keravive in−office treatment once a month for 3 consecutive months with continuous daily use of the take−home spray throughout.

Do you have any of the following?
Have you recently?

I acknowledge the following:

  • Photos may be taken before, during and after the HydraFacial Keravive 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 Keravive treatment by the staff at .Wellness302

  • 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 Keravive treatments. I will alert the staff If there are any future changes to my medical history.

Information submitted, thank you!

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