• Microneedling Bundle Consent Form

    RHE Studio Microneedling Treatment Package Agreement & Client Acknowledgment
  • Format: (000) 000-0000.
  • Date of Birth*
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  • Format: (000) 000-0000.

  • Microneedling 3 Session bundle Agreement

    The Microneedling Bundle Package includes 3 microneedling treatments designed to be completed within a recommended treatment timeline for optimal skin results and consistency.

  • Package & Terms:

    • The 3-session microneedling package must be used within 4–6 months from the date of purchase for the best treatment results.
    • Recommended spacing between appointments is typically every 4–6 weeks, depending on skin condition and treatment goals.
    • Results vary between individuals and may depend on skin condition, lifestyle, home care, and treatment consistency.
    • Unused sessions after the recommended timeframe may not provide optimal results.

    *   

  • Booking Policy
    - Clients are responsible for booking their remaining appointments in advance to stay within the recommended treatment schedule.
    - Appointments can be booked:

    • Online through the booking site
    • By direct message
    • By text/email through RHE Studio

    - Availability is not guaranteed for last-minute bookings.
    - It is recommended to pre-book future sessions after each appointment.
    *   

  • Cancellation & Rescheduling

    • Standard cancellation policy applies to all package appointments.
    • Late cancellations or no-shows may result in a forfeited session/deposit according to studio policy.
    • Rescheduling should be done with adequate notice to maintain treatment timing and results.


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  • Treatment Acknowledgement
    I understand that:

    • Microneedling works through controlled skin stimulation to support collagen production and skin renewal over time.
    • Multiple sessions are recommended for best results.
    • Temporary redness, sensitivity, dryness, flaking, mild swelling, or breakouts may occur following treatment.
    • Proper aftercare and sun protection are essential after each session.
    • Healing times vary depending on skin sensitivity and intensity of treatment.
    • Results are not guaranteed.


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  • Contraindication & Health Changes
    I agree to inform RHE Studio before each appointment if I:

    • Become pregnant
    • Start using Accutane or prescription retinoids
    • Experience active acne outbreaks, cold sores, infections, open wounds, or skin irritation
    • Receive recent cosmetic treatments or injections
    • Experience changes in medications or medical conditions


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  • Package Policy

    • Package purchases are non-transferable and non-refundable.
    • Sessions cannot be exchanged for cash or other services unless approved by RHE Studio.
    • Expired or unused sessions may be forfeited at the discretion of the studio.


    *   

  • Client Consent
    I certify that I have read and understood the Microneedling Package Agreement and acknowledge the information provided above. I understand the recommended treatment timeline, booking responsibilities, and package policies.



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  • Understanding the treatment:

    Microneedling uses a device with fine needles to create controlled micro-injuries in the skin to stimulate collagen and elastin. It can improve the appearance of fine lines, scarring, pigmentation, and overall skin texture.

     

  •  Potential Risks & Side Effects. Initial below:

    1. Temporary redness, pinpoint bleeding, swelling, mild bruising, and tenderness are normal.*
    2. Infection, scarring, post-inflammatory hyperpigmentation, or allergic reaction are rare but possible. *
    3. Results vary depending on age, health, skin type, and at-home care.  *      
    4. Multiple treatments may be required for the best results.   * 

  • Pre-treatment Requirements. I agree to:
    1. Discontinue retinoids, BHAs, AHAs, exfoliants and harsh actives for at least 5-7 days prior to treatment.*
    2. Avoid sunburn or tanning 1 week prior. *
    3. Avoid alcohol or anti-inflammatory medications 24 hrs prior (unless prescribed by a doctor).  *      
    4. Notify the provider of any changes to my health or medication.*   

  • Post-Treatment Requirements. I understand and agree to follow these aftercare instructions:

    1. Avoid touching the treated area for at least 4 hrs.

    2. No makeup, heavy exercise, swimming, or saunas for 24–48 hrs post-treatment.

    3. Only use approved post-care products provided or recommended by RHE Studio.

    4. Avoid harsh actives (retinoids, acids, scrubs) for at least 5–7 days post-treatment.

    5. Use SPF 30+ daily and limit direct sun exposure.

    6. Expect redness, mild swelling, and possible pinpoint scabbing for up to 3 days.

    7. Contact the studio immediately if signs of infection, excessive swelling, or prolonged discomfort occur.

  • Do you have any of the following medical conditions:

  • Acknowledgement & Consent:

    • I have disclosed all relevant medical history, medications, and allergies.
    • I understand the nature of the procedure, its benefits, and its potential risks.
    • I have been given the opportunity to ask questions.
    • I understand this is an elective, non-medical procedure and results are not guaranteed.
    • By signing below, I give my full consent to undergo microneedling at RHE Studio.
  • Photo/Marketing Consent:*
  • Date:*
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