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Laser Hair Removal Consultation Form 2018-06-13T22:30:41+00:00

Laser Hair Removal Consultation

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Laser Hair Removal Consultation

Personal Information:








Medical History:


Bleeding disorderBruise easilyEndocrine / hormone issuesDiabetesLupusPigmentation disorderPacemaker / defibrillatorEpilepsyLymphatic/Immune system DisorderHistory of cold soresAccutane within 6 monthsHistory of keloid inflammation scarringHistory of skin cancerDermatological conditionsPhoto allergicSteroids TherapyHigh blood pressureHistory of cancerPacemaker or internal defibrillatorAny abnormal or undiagnosed pigmentationLaser resurfacing in treatment area within 3 monthsAre you Pregnancy

Are you currently taking any medications or supplements please specify your condition:


Currently using /used allergies In the last 3months any of the following


St John WortAnticoagulantsAntibioticsGold medicationAccutaneRetin ANone


Has the area which will be treated ever had any of the following


Chemical peelsBotoxInjectable FillersLaser or IPL beforeNone

Your skin: What Products do you use on your skin?

Please indicate how your skin responds to midday summer sun exposure with no sunscreen protection.


Skin Type 1 Always burns, never tans.Skin Type 2 Easily burnt, eventually gets a moderate tan.Skin Type 3 Sometimes burns quickly gets a deep tan.Skin Type 4 Rarely burns, quickly gets a deep tan.Skin Type 5 Very Rarely burns, consistent tan.Skin Type 5 Never burns, consistent tan.


RealFake


YesNo


Pre-treatment check list to be completed by the operator


How treatment worksPre post treatment careSPF adviceTypical no of treatments/intervals Likely clinical outcomeSensation during TreatmentPossible side effects

Consent:

The information I have given is correct to the best of my knowledge, and I have not withheld any know medical state or condition. I will inform the LASER technician before treatment if there has been any change (for example in my medications taken)

I understand that the results from this treatment vary considerably and a small percentage of people will not respond depending on your hair type satisfactory to the treatment.

I understand that multiple treatments are necessary to get the best results as the amount of treatments will vary from client to client.

I understand there is no guarantee of permanent results and maintenance treatment may be necessary.

I understand that I must avoid sun exposure on the treated area for the duration of the treatment for up to 1 month afterwards or a use of high sun protection factor to avoid sun damage. I understand that tanned skin cannot be treated.

I understand that there may be short – term side effects such as reddening, brushing, swelling, mild burning, hypo pigmentation (lightening of the skin) or hyper pigmentation (darkening of the skin) as well as a rare side effect or scaring and permanent discolouration.

I understand that pigmentation areas caused by damage may initially turn darker. This will be followed by micro –crusting of the lesion, after which will flake away without leaving damage or pigmentation.

I understand that I must wear protective goggles which will protect my eyes any from possible damage due to the light.

I have read and understood all the information and my questions have been answered satisfactory before signing the consent form I consent to the terms of this agreement

I also agree that Beauty On The spot have the rights not to refund after 14 day of purchase.



Refund Policy

There are no refunds on package or per treatment purchases, gift certificates, and/or open products. If a laser package has been prepaid and a client chooses to discontinue treatment, the remaining credit can be applied toward other services offered by Beauty Centre.

If medical conditions restrict a client’s treatment program, their account will placed on hold until they can continue services.

Beauty Centre makes no guarantees on any service or product as results can vary from one client to the next.

Follow-up treatments

For some laser hair removal clients, follow-up treatments may be needed. Pricing for follow- up treatments will be discussed during your initial visit.

Your signature below is an agreement and understanding of our refund and follow-up policies.



Cancellation Policy

In effort to use our business hours more efficiently, Beauty Centre is now enforcing a cancellation policy. While consideration will be given to extenuating circumstances, we ask that you give us 48 hours notice if you cannot make your appointment.

As always, we value your business and thank you for choosing us.

I understand that a £25.00 cancellation fee will be charged if I do not show up for my appointment or fail to cancel my scheduled appointment without giving a 48 hour notice.



Referral Program

We know the best form of advertising is word of mouth. If you love our services, your friends will too! For every new person you refer to us that purchases a laser hair removal package from us, we will give you a credit of £10.00 to use for future services!

The only requirements are that your friend must give us your name at the time of their first visit and they must purchase their services directly from Beauty Centre.


I Agree, that my data will be stored



Weymouth Beauty Hair Salon Fees. Beauty Salon, Beauty, Salon, Weymouth, Treatments. Truly Scrumptious, 9am, Truly Scrumptious Beauty, Weymouth salon, Wrinkle Treatment. Dermal Fillers, Lip Fillers, Permanent Makeup, Chemical Facial Peels, Hands. Feet, Nails, Manicure, Pedicure, Make Up. Mesotherapy, Hair Salon, Massage, Excessive Sweating, Laser Hair Removal, Microblading.

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