Dermaplaning Consultation Form

Name

First NameLast Name

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Have you ever had a dermaplaning facial preformed by a professional?

In the last 48 hours, have you had a peel, microdermabrasion, or tanned?

What is your skin type?

Are you sunburned on your face right now?

Do you have any allergies?

Other

Please list all your allergies/allergens.

I understand this procedure removes most, not all vellus hair (peach fuzz)

I understand that direct sun exposure, including tanning beds, is not recommended while undergoing treatment and the use of a daily sun block protection is mandatory

I understand that any facial injections should be avoided 10 days before this treatment. I am not using Retin A, and have been off Retin A for at least 3 days prior to treatment. I will call my practitioner if I have any questions or concerns about my treatment

I have been advised not to exercise after my treatment.

Avoid Touching Your Face. Refrain from touching your face to prevent transferring bacteria or oils that could cause irritation or breakouts.2. Keep Your Skin HydratedApply a gentle, hydrating moisturizer immediately after your treatment and continue to do so for the next few days. Look for moisturizers with calming ingredients like aloe vera or hyaluronic acid.3. Avoid Makeup for 24 HoursTo allow your skin to breathe and avoid clogging your pores, refrain from applying makeup for at least 24 hours after dermaplaning.4. Avoid Sun ExposureYour skin will be more sensitive after dermaplaning, so avoid direct sun exposure for at least 24-48 hours. If you must go outside, apply a broad-spectrum sunscreen with SPF 30 or higher to protect your skin.5. No ExfoliationAvoid using exfoliating products, such as scrubs or chemical exfoliants (AHA/BHA), for 5-7 days post-treatment to prevent irritation.6. Avoid Heat and SteamFor 24-48 hours, avoid hot showers, saunas, or steam rooms, as excessive heat can irritate freshly treated skin.7. Gentle SkincareUse gentle, non-irritating products in the days following your treatment. Opt for mild cleansers, and avoid any harsh products like retinoids, acids, or alcohol-based toners for at least 3-5 days.

I hereby agree to all of the above and agree to have this treatment performed by Angelica Blacha. overseen by DR. Hameed further agree to follow all post-care instructions. Prior to receiving any treatment, I have been candid in revealing any condition that may have bearing on this procedure. I am over 16 years of age..

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