• Intimate Lightening

    CLIENT INTAKE & MEDICAL HISTORY
  • Date of Birth*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Format: (000) 000-0000.
  • What are your area(s) of concern for treatment?*
  • Are you currently taking any blood thinning medication?*
  • Are you currently?*

  • Medical History

    Please check all that apply
  • Have you ever had an allergic reaction to any of the following?*
  • Check the conditions that apply*

  • Consent and Liability Wavier

    Initial each section.

  • Intimate Lightening is a cosmetic procedure used to treat hyperpigmentation concerns in intimate areas. The process involves cleansing, microdermabrasion, intimate peel, lightening serum and moisturizer. This treatment can be done every 7 days until the desired results are achieved. Thereafter, routine maintenance is recommended. 

    Please read and initial the following statements:

  • I understand that results will vary between individuals. I understand that although I may see a change after my first treatment, a series of multiple treatments is recommended to see ideal results. *
  • I understand that several treatments will be required to reach the desired results and a treatment plan has been discussed with my Technician. I understand that no guarantee can be given regarding final results.*
  • I hereby give my informed consent to receive Intimate Lightening Treatments. I have read and fully understand this agreement and all information detailed above. This agreement will remain in effect for this and all subsequent Intimate Lightening Treatment conducted by Body Adore.*
  • Due to nature of this treatment, we take photos for progress tracking and marketing purposes. Your identity is kept confidential if you consent. Do you agree to be photographed or videotaped before, during, and after treatment? We shall own the photos and recordings.*
  • Should be Empty: