Electrolysis Consultation & 10-minute Trial Intake Form

ACKNOWLEDGMENT OF INFORMATION

I understand health history information is important to the Electrologist in order to provide with safe and effective electrology treatments.I acknowledge all information given by me is accurate to the best of my knowledge and I agree to update my health history assessment whenever there are changes. I understand that a series of treatments is necessary to achieve permanent hair removal based on my previous temporary method of hair removal, the science of electrology, and my individual physiological factors. I have been advised of the post-treatment healing process and the possible risks related to treatment. I agree to follow all aftercare instructions and to notify the Electrologist or any concerns or difficulty in healing.