Sleek Laser Solutions expands to Frisco. Enjoy premium laser hair removal services at our new location!

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Medical History and Consent Form

Home / Medical History and Consent Form

Medical History & Consent Form

First Name

Last Name

Phone/Mobile

Date of Birth

Are you currently pregnant?

Yes

Are you breast feeding?

Yes

Have you ever taken accutane?

Yes

When was the last time you were on it?

Any sun exposure from the past two weeks?

Yes

Any spray tan or tanning bed in the past two weeks?

Yes

How would you describe your skin in the sun?

Always burns, never tans

Rarely burns, always tans

Other

Please explain:

Any allergies?

Yes

Please explain:

List antibiotics if you have taken in the past two weeks?

Any medical condition or health problem we should be aware of?

Herpes

HIV

Infection

Cancer

Hormonal Imbalance

Skin Lesions

How were you referred to us?

Google

Facebook

Instagram

Website

Friend

Other

Please specify

Can we take pictures of your before and after results?

Yes

I agree with the below statement:

I understand I will require several treatments to achieve long-term results for permanent hair reduction. I understand that sun exposure before or after the treatment for long periods can enhance rare side effects. After the treatment, I understand I might have short-term redness, red bumps, itchiness, pain, tingling sensation, or numbness. Although very rare I also might have side effects of bruising, burning hyperpigmentation, hypopigmentation, and infection.

CANCELLATION POLICY: There will be a cancellation fee of 50% of your appointment charge if cancelled within 12 hours of your appointment time. (Fee will be collected at your following appointment)

NOTE: Please do call us if you have an emergency

Signature

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⚲ 9669 N. Central Expy # 250-4 Dallas, TX 75231
⚲ 8250 Gaylord PWKY STE # 3 Suite # 11 Frisco, TX 75034
info@sleeklasersolutions.com
+1 (214) 251-8004
Opening Hours
Monday - Friday
(8 am - 8 pm)
Saturday - Sunday
(10 am - 7 pm)
Laser Hair Removal Frisco
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