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Microdermabrasion & Diamond Glow Consent Form

DermaRadiance™ Patient Information Card

Prepared especially for clients considering DermaRadiance™ microdermabrasion & diamond wand services. Satin Smooth’s MicroDermabrasion is the new, non-invasive, convenient skin care technology that is specially designed for men and women who want to look their best, regardless of age. Satin Smooth does not assume any responsibility to this consent form.

Client questions:

Is your skin sensitive?
Are you pregnant or planning to be?
Do you smoke?
Do you have or have you ever had any of the following:
Have you ever had any of the following treatments:
I do fully understand all the questions above and have answered them all correctly and honestly. Furthermore, I know that it is my responsibility to alert the clinician about any recent surgeries or skin resurfacing procedures. Without the above disclosure I understand that the attending technician cannot optimize the effectiveness of DermaRadiance™ microdermabrasion & diamond wand services, which are designed to provide clients with superior results. By signing below I consent to the Satin Smooth DermaRadiance™ microdermabrasion & diamond wand procedure.
Clear Signature