Consent Form: Hydrafacial

Hydrafacial MD©️ Client Consent Form

This is an informed consent form which has been prepared to help your esthetician inform you of HydraFacial's risks, likely effects and alternative treatments. Please read carefully through this form, and answer all questions truthfully. Complete and sign before your appointment.
HydraFacial is a hydradermabrasion treatment that delivers long-term skin benefits. Hydrafacial uses vortex-fusion technology to cleanse, exfoliate, extract, and hydrate the skin. Hydrafacial offers noticable results with little-to-no downtime.

WHAT TO EXPECT:
• Your skin may experience temporary irritation, tightness, or redness. These are all normal reactions that typically resolve within 72 hours depending on skin sensitivity.

• You may experience tingling and stinging in the treated area. These sensations generally dissipate within a few hours.

• It is possible to see immediate results after treatment. Post treatment the skin will more than likely feel smooth, plump and hydrated.

• The skin does become more sensitive to the sun right after a treatment. Therefore, we advise clients to avoid extreme sun exposure and to always wear a suncreen of SPF 30+
Do you have any of the following? Select all that apply.
Please list all current medications:
Please list any known allergies:
Have you recently received any of the following? Select all that apply.
Elevate your spa experience with a Hydrafacial antioxident or hydration boosters. Select booster you wish to add on to your service.
Who will be your service provider for this appointment?
I acknowledge the following:
- I will avoid the use of aggressive exfoliation, waxing, and products containing glycolic acids or retinols that are not part of the recommended take-home regimen in the treated areas for minimum 2 weeks pre-and post-treatment.
- Photos may be taken before, during and after the HydraFacial 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 treatment by the staff at Clementine's Salon and Skin Care.
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 treatments. I will alert the staff If there are any future changes to my medical history.
By signing, I certify that I have read and fully understood the contents of this consent form. The information I provided is complete, accurate, and up-to-date to the best of my knowledge. I freely consent to the proposed treatment today as well as future treatments as needed.

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Hydrafacial MD©️ Client Consent Form