WP E-Signature by Approve Me - Sign Documents Using WordPress -

CONSENT FORM FOR DERMAPLANING

Dermaplaning is a non invasive, painless procedure that utilizes a surgical blade to resurface dead skin cells and remove superficial facial hair. At Dermatology Partners lnc., the dermaplaning procedure is immediately followed by a mild peel for further exfoliation. Dermaplaning requires no recovery time. It increases cellular turnover as well as smoothes and softens skin. Results with dermaplaning can be visible immediately.

The procedure may cause stinging and discomfort, usually lasting a short period of time. lt may also cause redness. Occasionally some swelling may occur. The skin may peel and could continue to do so for up to one week. The hair that is removed as a result of dermaplaning is expected to grow back blunt-ended. New hair will not appear darker or denser. However, any hormonal imbalances that may be present can alter the normal hair growth pattern and cause a darker, denser restoration process.

Prior to this treatment I have been candid in revealing any condition I have that may have a bearing on this procedure, such as cold sores, allergies, recent facial peels, surgery, use of retinol, Accutane or hormones.

Please initial and sign below.

I understand that dermaplaning is the process of removing superficial layers of dead skin cells by the use of a sterile blade.

I understand that optimal results may not be seen in a single treatment. The ideal plan of treatment will include more than one dermaplaning treatment as directed by my aesthetician to enhance any skin conditions and follow up with maintenance treatments as needed.

I understand the importance of my strict adherence to the pre-treatment and post treatment instructions.

I understand that there may be unforeseen risk with dermaplaning such as cutting, scraping, or abrading the skin with the blade.

I have received an instruction sheet as how to care for my skin following this procedure and agree to abide by it.

I am over 18 years of age or I have parental consent co-signed below.I am satisfied with the information provided to me regarding dermaplaning and agree to have the procedure performed on me.

Date:

Leave this empty:

Your legal name

Your email address

Please Confirm full name and signature.

Draw Signature
Type In Signature

Draw your signature with your mouse, tablet or smartphone Clear

I agree that I am and I agree this is a legal representation of my signature for all purposes just the same as a pen-and-paper signature