• GlacialFX Treatment Consent Form

  • Glacial fx uses controlled cooling to improve skin wellness and stimulate healthy, beautiful, more youthful-looking skin. The treatment delivers a refreshing sensation. Multiple treatments may be desired for optimal results. Treatment plans will vary depending on your individual skin goals. Speak to your provider to discuss your treatment options. 

    What to expect:

    During your Glacial Gloss and/or Glacial Glide treatment, you may feel an overall refreshing sensation when all-over cooling is applied. During your Glacial Gloss treatment, you may feel mild tingling or warmth during the all-over cooling step if topicals containing mild chemical exfoliants such as glycolic, lactic, and salicylic acids are used. 

    Potential effects and risks:

    You may experience one or more of the following anticipated effects following the use of topicals with the all-over treatment:

    • Transient redness and sensitivity
    • Skin sensitivity to sun exposure
    • Mild skin irritation
    • Temporary skin dryness Temporary skin purging/acne breakout
  • Do you have any of the following?
  • As with any elective treatment, there are potential effects and risks. These have been explained to me and I have read the above information. I give consent to my provider to receive the Glacial treatment today.

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