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HydraFacial Consent
Medical Questionnaire

Terms of your treatment

I acknowledge that I am not pregnant or breastfeeding, avent use Roaccutane within the last 6 months, haven't received any cosmetic injectables within the last 2 weeks, I don't suffer from cancer and autoimmune disorders and I do not have any known allergies to shellfish. I have specified any other allergies I have on my medical questionnaire.

I have received a full consultation and explained Perk/HydraFacial treatment and all my questions were answered.

I acknowledge there is no guarantee to the results of the treatments and acknowledge the need for continual care for the extension of the treatment results.

I acknowledge it is my responsibility to use a minimum SPF 30 following my treatment.

I understand that there may be skin reactions to the ingredients or the treatment itself, and skin may experience temporary sensitivity, tightness, redness, itchiness and swelling. All of these affects will resolve themselves within days to weeks depending on skin sensitivity.

I understand that is it my responsibility to avoid Retinol, Retin-A products pre and post Perk/ Hydrafacial for a minimum of 2 days.

I hereby agree to have the treatment performed and agree to follow all pre and post treatment instructions.

My practioner may use pictures/videos taken before or after my treatment for social media or in-clinic purposes. Please tick the appropriate box if you agree or disagree.

I certify that I have read and fully understand the above consent form, I have understood the terms of the treatment and the medical questionnaire is accurate.

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