Chemical Peel Consultation Form

PLEASE READ: This form is ONLY for CHEMICAL PEEL clients! Do not submit this form if you are not booking a chemical peel appointment. 

FOR CHEMICAL PEEL CLIENTS: Please fill out and submit this form prior to coming to your appointment. If this form is not submitted, you will be required to fill out a paper one upon arrival to your appointment. 

You may experience some tightening of the skin during treatment and after which may last for several days. darkening and flaking may occur which may last for 3 to 10 days. It is recommended that you do not pick or peel the flaking skin off as it may scar. Skin renewal may take longer than usual than the other parts. 

During the post treatment, it is highly important to do the following:

1. Apply sunscreen protection daily, we require at least an SPF 30 sunscreen to be used.
2. Please do not apply makeup immediately after treatment.
3. Avoid any physical activity that could increase your blood circulation to the face within 24 hours after treatment.
4. Avoid direct sun for 2-3 weeks after treatment.
5. Do not use any other products on your treated skin area for at least 72 hours.
6. As stated above, do not pick or peel at loose or flaking skin.
7. Keep away from heat sources.

I declare that the information provided above are true and correct to the best of my knowledge. I have I understand and I voluntarily accept the treatment that I will undergo and I understand the risks and benefits involved in the procedure.

I have carried out a patch test and found satisfactory results. I have had the opportunity to ask questions regarding the treatment and answers were given to me to my satisfaction.

In case of adverse effects during or after treatment, I agree to notify the clinic immediately.