Advanced Facial & Galvanic Information Consent Form

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What should you expect during your treatment?

Prior to your first treatment a thorough skin analysis will be performed. If treatment is not appropriate, you are informed during this session and an alternative treatment may be recommended instead. If treatment is appropriate, maximum results are obtained by participating in a series of treatments plus following a home care regimen. To further enhance your outcome, products specifically directed toward obtaining correction are highly recommended. Your current daily regimen and skin care products used will be reviewed, and you will be instructed which products you should continue to use, and will be advised on any recommended additions to your regimen. It is recommended to keep regular appointments and carefully follow your home care regimen to support your results.

I have read and understand the above

We take every precaution to ensure that your skin is well hydrated and calm prior to leaving each session. However, you may experience excessive dryness and/or peeling between sessions, which may or may not be normal. Always check with the esthetician if you have any concerns after the treatment. More sensitive skin may experience some redness after the first couple of sessions. This normally goes away after 2 to 3 hours. After your treatment, sunblock must be worn at all times and tanning beds should never be used.

I have read and understand the above

Is satisfaction guaranteed?

Maximum results are highly dependent on your age, cumulative sun exposure, health, menopause, lifestyle, genetic traits, general skin condition, and your willingness to follow recommended protocols. Be aware that many changes may occur deeper within the skin over time. Participation in a series of treatments, along with a commitment to your daily skin care regimen may produce noticable differences. You may see a reduction of fine lines and a softening of deeper wrinkles, reduction of discoloration, softening and possible reduction in scars, and an overall improvement to the skin's tone and appearance.

I have read and understand the above

Contraindications

Although it is impossible to list every potential risk and complication, the following conditions are recognized as contraindications for advanced facial treatment and must be disclosed prior to treatment:

  • Active infection of any type, such as Herpes simplex virus or flat warts.
  • Active acne
  • Sunburn
  • Uncontrolled diabetes
  • Eczema, dermatitis
  • Recent use of topical agents such as glycolic acids, alphahydroxy acids and Retin-A
  • Any recent chemical peel procedure
  • Skin cancer
  • Vascular lesions Oral blood thinner medications
  • Rosacea
  • Tattoos (not effective)
  • Pregnancy
  • Use of Acutane within the last year
  • Family history of hypertrophic scarring or keloid formation
  • Telangiectasia/erythema may be worsened or brought out by skin exfoliation
  • Epilepsy
  • Metal implants/braces
  • Pacemakers
  • Heart conditions
I have read and understand the above

Post-Treatment / Home Care

Aerobic exercise or vigorous physical activity should be avoided until all redness has subsided. Direct sunlight exposure is to be completely avoided immediately following the treatment (including any strong UV light exposure and tanning beds). If some sun exposure cannot be avoided, first apply sunscreen with an SPF of 30 or greater. Although sunscreen should be a part of your daily skin care, for a minimum of two weeks, a sunscreen with at least a SPF of 15 must be applied.

Cleanse your face with water or a mild soap substitute twice daily followed by a mild sunscreen (minimum SPF 30). If a site other than the face is treated, you only need to cleanse once daily, followed by sunscreen. In the event that you may have additional questions or concerns regarding your treatment or suggested home product / post-treatment care, you must consult your esthetician immediately.

I have read and understand the above

I have read the advanced facial Information Sheet and fully understand what to expect. If I have questions or concerns I will address these with my esthetician. I will also keep my esthetician updated on my physical health.

I have read and understand the above

Informed Consent

Please sign to state that you read and understand the policy

I have read the Advanced Facial Information Sheet and fully understand what to expect. If I have questions or concerns I will address these with my esthetician. I will also keep my esthetician updated on my physical health.

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