Skin Imperfection Consultation Form
  • Skin Imperfection Curections Form

    REQUIRED FOR ALL TREATMENTS PRIOR TO APPOINTMENT
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  • Thank you for your interest in our " Imperfection Cur-rections" services. As each service begins with a consultation. This inquiry sign up will assist our staff on deciding if you are a great candidate for this non-invasive service as we only treat specific malignant skin lesions. Below is a list of frequently asked questions:

     

    FAQ:

    What type of treatment do you use to remove moles/skin tags?
    We use a device called the SIIT Pro. It emits a high-frequency current that zaps skin irregularities.

    Is the high-frequency treatment painful?
    On a scale of 1 to 10, clients describe the discomfort level as a 3.

    How does it work?
    A small probe lightly touches the skin to vaporize the affected area creating a small crust that heals and eventually falls off.

    Is this treatment permanent?
    This treatment will permanently address the current skin lesions - however, as some of these conditions are genetic, new growths commonly appear over time. Proper home care slows down the acceleration of new growths.

    How many treatments will I need to have?
    Results can be seen after one treatment. However, your skin therapist may recommend several sessions. A follow-up visit is required.

    Are there any side effects?
    The most significant risk is hypo or hyperpigmentation. Strictly following the post-care guidelines will ensure a positive outcome.

    How long does a treated skin tag take to heal?
    While there is no real downtime, the skin takes anywhere from 4 – 15 days to heal completely. The client can apply makeup to conceal the treated area 48hrs after treatment; however, best practices suggest waiting until the area
    has healed.

    What are the contraindications to receiving this treatment?
    Visibly inflamed or irritated skin is a contraindication: pregnancy, recent use of Accutane, large flat lesions,Melasma, electrical implants (pacemaker).

    Who are the ideal candidates?

    The ideal candidate has realistic expectations and will closely follow the aftercare and continued home care. Skin pickers are not ideal candidates

  • Your Health

    Please answer all questions truthfully and to the best of your knowledge
  • Tell Us About Your Skin

  • Female Clients Only

  • Male Clients Only

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  • Photo Release

  • In consideration of my engagement as a model, and for other good and valuable consideration herein acknowledged as received, I hereby acknowledge the following rights and permissions belong to Ladi Lyke, La Beau Monde LLC; DBA: Virtuoso Beauty & Co., and his/her heirs, legal representatives, and assigns those for whom Photographer is acting, and those acting with his/her authority and permission. They have the irrevocable, perpetual, and unrestricted right and permission to take, use, re-use, publish, and republish photographic portraits or pictures of me or in which I may be included, in whole or in part, or composite or distorted in character or form, without restriction as to changes or alterations, in conjunction with my own or a fictitious name, or reproductions thereof in color or otherwise, made through any medium at his/her studios or elsewhere, and in any and all media now or hereafter known, specifically including but not limited to print media and distribution over the internet for illustration, promotion, art, editorial, advertising, trade, or any other purpose whatsoever.

    I consent to the digital compositing or distortion of the portraits or pictures, including without restriction any changes or alterations as to color, size, shape, perspective, context, foreground, or background. I also consent to the use of any published matter in conjunction with such photographs.

    I hereby waive any right that I may have to inspect or approve the finished product or products and the advertising copy or other matter that may be used in connection with them or the use to which they may be applied. I hereby release, discharge, and agree to hold harmless Photographer, his/her heirs, legal representatives, and assigns, and all persons acting under his/her permission or authority or those for whom he/ she is acting, from any liability by any blurring, distortion, alteration, optical illusion, or use in composite form, whether intentional or otherwise, that may occur or be produced in the taking of such photographs or in any subsequent processing of them, as well as any publication of them, including without limitation any claims for libel or violation of any right of publicity or privacy. I hereby grant permission to the individual or company that provided my treatment to use any photographic treatment records for the purposes of clinical and statistical studies, advertising, or promotion without any additional compensation to me.

    I hereby warrant that I am of full age and have the right to contract in my own name. I have read the above authorization, release, and agreement before its execution, and I am thoroughly familiar with this document's contents. This document shall be binding upon me and my heirs, legal representatives, and assigns.

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  • Consent to Treat

  • Ladi Lyke has explained to me that the SIIT Pro treatment is a popular
    and effective treatment for the cosmetic care of many minor superficial skin irregularities that are encountered daily.

    As with any cosmetic procedure, the goal is for esthetic improvement, not perfection. Risks associated with the SIIT Pro are minimal and may include burns/scabbing, skin discoloration, and scarring; thus, it is imperative to follow home care advice to minimize these risks.

    I attest that I am unaware of any underlying conditions (e.g., skin cancer or skin diseases).
    I understand that several factors, including skin color, age, ethnicity, hormonal activity,
    inherited disorders, and other influences, may decrease these cosmetic treatments' effectiveness.

     

    Please read and initial the following statements. Upon reading and agreeing please intial.

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  • Client Commitment

    • I will not use any other products that have not been approved by my skincare professional while I am on their regimen.
    • I will not change the regimen given to me by my skincare professional without notifying or consulting them first.
    • I will replenish my products well before I run out, so that the best results may be achieved as recommended by my skincare professional.
    • I will not have other skin care treatments while I am being treated by my skincare professional.
    • I will inform my skincare professional of any medications/drugs that I start taking while using their recommended products.
    • I will use my sunscreen every morning, regardless of whether or not I will be going outside.
    • I will not get sunburned or wind burned while being treated by my skincare professional.
    • You will not be able to use your active products; and we will not be able to do treatments on you (if you are seen in our studio).
    • I will inform my skincare professional if I elect to do any laser treatments or waxing for hair removal.
    • (For women) - I will inform my skincare professional if I get pregnant.
      I agree to contact my skincare professional so we can adjust the home care regimen per their recommendations.
    • I agree to contact my skincare professional if my skin gets uncomfortably dry and irritated.
    • I agree to commit to appointments and am aware that my skincare professional may choose to stop treating me before the best results are achieved if I miss more than 2 appointments without
      proper notification. This also applies if I am late to more than twice to appointments.

    MOST IMPORTANTLY:

    If we are unable to improve the condition of your skin due to factors beyond our control, but within yours, we reserve the right to decline treatments. (That is, if you are not following our instructions pertaining to home care, doing your home care, lifestyle issues, etc)

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