Consent Form
Hollywood Spectra
I have been advised of the following:
- The possible risks of the procedure include but are not limited to pain, swelling, redness, bruising, blistering, crusting/scab formation, ingrown hairs, infection, and unforeseen complications which can last up to many months, years or may be permanent.
- There is a risk of scarring.
- Short term effects may include reddening, mild burning, temporary bruising or blistering. A brownish/red darkening of the skin (hyperpigmentation) or lightening of the skin (hypopigmentation) may occur. This usually resolves in weeks, but it can take up to 3 – 6 months to heal. Permanent color change is a rare risk. Loss of freckles or pigmented lesions can occur.
- Although infection following treatment is unusual, bacterial, fungal and viral infections can occur. Herpes simplex virus infections around the mouth can occur following a treatment. Should any type of skin infection occur, additional treatments or medical antibiotics maybe necessary.
- Pinpoint bleeding may occur following treatment. This may result in scarring.
- Compliance with the aftercare guidelines is crucial for healing, prevention of scarring, and hyper-pigmentation.
- I understand that multiple treatments will be necessary to achieve desired results. No guarantee, warranty or assurance has been made to me as to the end results.
- My questions regarding the procedure have been answered satisfactorily.
- I understand the procedure; I accept all risks and consent to undergoing treatment.
- I agree that photos may be taken as part of my treatment record and remain confidential.
- I have read and received a copy of the Client Information, After Care Instructions and Consent Form.
- I must wear eye protection as advised by my therapist.