Microchanneling (ProCell Therapies)

I authorize Deborah King of Chandelier Hair Studio to perform Microchanneling
on my scalp, and to apply topical preparations as determined necessary.   

I understand, that Procell Microchanneling for hair regrowth involves the creation of perforations in my scalp to promote delivery of product to reactivate dormant follicles. I understand that the procedure is performed with an automatic perforating device and that clinical results may vary. I understand there is a possibility of short-term effects such as pain, reddening, peeling, scabbing, temporary bruising,temporary discolouration of the skin, as well as rare side effects such as infection & scarring. These effects have been fully explained to me.

Clinical results may vary depending on individual factors, including medical history, amount of, and longevity of hair loss, and my compliance with pre/post treatment instructions. I understand that the Microchanneling treatment may involve a series of treatments and that the fee structure has been fully explained to me. I certify that I have been fully informed of the nature and purpose of the procedure, expected outcomes and possible complications, and I understand that no guarantee can be given as to the results obtained, and that there are no refunds offered for lack of satisfactory results.

I am fully aware that my condition is of cosmetic concern and that the decision to proceed is based solely on my expressed desire to do so.    

I confirm that I am not pregnant at this time. I also have completed a medical history checklist and been informed about what I must do and “not do” before, during and after the procedure.   

I consent to the taking of photographs and authorize their anonymous use for the purposes of clinical audit, education, and promotion.

I certify that I have been given the opportunity to ask questions and that I have read and fully understand the contents of this consent form. 

I furthermore indemnify the authorized person herein, and hold harmless from any, and all claims, demands, liabilities, judgments, costs and expenses arising out of any claims relating to the procedure authorized herein.

NOTE: If you experience any abnormal discomfort/infection (outside of what has been explained to you in the post treatment) you must seek your doctor or medical practitioner's advice. 

Cancellation and Refund Policy

• There are no refunds under any circumstances.
• Cancellations accepted up to 48 hours before the scheduled service.
• Within 48 hours of the service, cancellations will be charged at 50% of the scheduled cost.
• All no shows will be charged at 100% of appointment costs.
• All outstanding cancellation fees must be paid prior to rebooking.