Dermaquest, Dermaplaning, Microneedling, Dermalux Flex MD and Platelet Rich Plasma (PRP) Consultation form.

General Disclaimer

• I understand multiple treatments may be necessary to achieve optimal results
• I understand that is no guarantee of permanent results and maintenance treatments may be required
• I understand that there be side effects or bruising, reddening, swelling and rarely mild burning or blistering.
• I understand the Dermaplaning treatment involves the use of a sterile surgical blade to remove dead skin cells and vellus hair. As with the use of any sharp instrument there is a risk nicks or cuts while every precaution is taken, I understand the risk

Dermalux Flex MD Disclaimer

• I confirm that I have answered all the questions to the best of my knowledge and understand that withholding necessary information about my health and medication may increase my risk of possible side effects.
• I will inform my practitioner before every treatment if there has been any change to my circumstances or medication I may be taking.
• I understand that the Dermalux systems have not been tested on pregnant women and therefore the risk to the foetus or pregnant woman is unknown.
• I understand the benefits and likely clinical outcome of the Dermalux treatment and that multiple treatments are necessary to achieve optimal results.
• I acknowledge that no written or implied verbal guarantee, warranty or assurance has been made to me regarding the outcome of the procedure.
• I agree that I have read and understood all the information provided. My questions have been answered satisfactorily and I have made an informed decision to receive the Dermalux treatment.