SkinPen Consent Form
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DESCRIPTION OF SERVICE

Microneedling treatment allows for controlled induction of the skin's self-repair mechanism by creating  “micro”-injuries in the skin, which triggers collagen synthesis, yet does not pose the risk of permanent  scarring. The result is less textured, smoother, more firm, youthful looking skin!

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POSSIBLE SIDE EFFECTS

After the procedure, the skin will be red and flushed in appearance to a moderate sunburn. You may  also experience some skin tightness and mild sensitivity to the treated area. This will diminish greatly in the  next 24-48 hours post procedure. After 3 days, most, if not all, redness will be gone. After 7-10 days you  will be healed. You should apply sunscreen DAILY to your skin. Do Not be in direct sunlight for 24 hours post procedure. Discontinue any retinol for the next week as well. 

Some possible side effects include: skin redness, flaking/itching, short-term swelling, fever blisters, bruising, and infection.

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PATIENT CONSENT

I understand that results may very upon individuals.  

I understand that I may need multiple treatments to achieve desired results. I understand that at home  skin care maintenance is required to achieve optimal results.  

I am NOT pregnant or lactating. 

If outdoors, I will apply SPF of 35 or higher 30 minutes prior of sun exposure. 

In rare cases, allergies or sensitivities have been reported to products during procedure. 

The procedure and side effects have been explained to me. I am advised that though good results are  expected, the possibility and nature of complications cannot be accurately anticipated and that there can be no guarantees expressed or implied either as to the success or other results of the treatment.

I am aware that microneedling treatment is not permanent as natural degradation will occur over time. 

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Required
I understand that I will undergo microneedling treatment and fully consent to have this procedure performed. 

Please type your full name below to consent.

I release Licensed Aesthetician Mikayla Milligan, staff, and specific technicians from liability  associated with this procedure.  

PLEASE TYPE YOUR FULL NAME BELOW TO CONSENT.

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