I authorize White Pearl Medspa & Laser to perform Micro-Needling treatments for me.

I understand that Micro-needling is a treatment wherein a fine needle will be introduced through the skin. This will combine active ingredients to go deeply into the dermis. Normally, 3-6 treatments are required to see the results.

I understand that I might experience the following side effects and will confirm that it is normal. I also understand that it will go back to normal within 24-48 hours.

• Flushed or red skin
• The tightness of the skin
• Mild sensitivity to touch
• Moderate sunburn
• Itching and burning
• Little white dots can appear following, typically these are retention
• Fever blister could occur

I confirm that I will follow the pre-care and post-care instructions by the specialist.

I understand that this procedure does not guarantee any specific result.

I understand the risks and complications of this procedure and I still like to proceed with it. These are the following risks: infection, hyperpigmentation, allergic reaction, scarring, pain, itchiness, or swelling.

I understand that this procedure or service is non-refundable.

I release White Pearl Medspa & Laser and its employees from any liabilities and hold them harmless against damages or accidents that might happen during the procedure.

I confirm that I had the chance to ask any questions about the treatment to the specialist and I received satisfactory replies.

I confirm that I will consult my physician if I have the following contraindications:

• Rashes, Epileptic
• Acne
• Skin infection
• Viral, fungal, bacterial infection
• Pregnant
• Diabetes, anxiety 
• Taking NSAIDs, Warfarin, or any anticoagulants
• Cardiovascular disease must receive written permission from PCP.