I hereby give my consent to undergo Collagen Induction Therapy (Micro-needling) treatments provided by licensed professional at Perfectly Bare Laser.

I understand this technique involves the introduction of fine needles through the skin. The purpose is to create micro-channels in the skin allowing the infusion of active ingredients such as PRP (platelet rich plasma), growth factors and hyaluronic acid to penetrate deeply and effectively into the dermis, nourishing the skin and stimulating the regrowth of collagen. A series of 3 to 6 treatments are recommended every 4 weeks to achieve optimal results.

I understand that the treatments involve many small needles on the area(s) to be treated. I understand that the administration of numbing creams may be used.

Micro-needling is not suitable in these circumstances:

⬥ Have used Accutane (isotretinoin) within the last 6 months. 

⬥ Have open wounds, cuts or abrasions on the skin 

⬥ Have had radiation treatment to the skin within the last year 

⬥ Have any kind of current skin infection, condition, herpes simplex in the area to be treated 

⬥ Are pregnant or breastfeeding 

⬥ Have any history of keloid or hypertrophic scars or poor wound healing

I understand that there are some risks with any procedure. The following are possible reactions with Micro-needling: temporary bruising, skin discomfort during treatment, redness or swelling, lightening or darkening of the skin, itching and burning. Skin infection is always a possibility when breaking the skin, although rare. Side effects are most of the time temporary and typically resolve within 3 days. Total healing time depends on the depth of the treatment, skin type, and skin condition, and some patients may heal completely in 24 hours.

By my signature, I certify that I have thoroughly read and understand the contents of this form and the disclosures listed above were made to me. I acknowledge that no promises or guarantees have been made to me as a result of the treatment. 

I am aware that the results achieved by this treatment may vary from person to person. Some patients typically notice an immediate glow, but visible improvement will take about 2-4 weeks and can continue for up to 6 months.

I have read potential risks have been explained to me and I accept them. I hereby give my voluntary consent to have this treatment performed on me.