• LAMPROBE Treatment Consent Form

    Maison de Peau, LLC.
  •  -
  • Maison de Peau's representative has explained to me that the LAMPROBE processes are popular and effective for the cosmetic treatment of many minor superficial skin irregularities. I consent to have the LAMPROBE utilized on me for the cosmetic treatment of:

  • Risks associated with the LAMPROBE treatment even though minimal but it can happen. The risks include burn/scabbing, skin discoloration and scarring. It is extremely important to follow home care advice to avoid scarring. In consenting to having the LAMPROBE performed on me, I hereby release and forever discharge the performing practitioner of said cosmetic treatment and Maison de Peau, its officers, employees and /or associated subcontractors, manufacturers, distributors and suppliers of an from all claims, demands, damages action or cause of action arising out of the performance of the said cosmetic treatment procedures.

  • Maison de Peau regularly documents the demonstration and use of the LAMPROBE using before & after photos and/or videos. I understand that all of the photos taken will be the property of Maison de Peau and may be used or shared at a later date for educational and/or marketing puroses and I conset to this use.

    I have read and agreed to the above conditions.

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