Appointment Name * Name First First Last Last Date of Birth * Email * Confirm Email * Please confirm your Email Address Phone * Best Day of Week/Time of Day to Call Type of Treatment * Botox Laser: IPL Treatment Laser: Hair Removal Treatment Laser: Erbium Yag Skin Resurfacing Laser: Long Pulsed Yag Vascular Reduction Laser: Tattoo Removal Treatment Filler Microneedling Consultation What are your concerns? * Laser: IPL Treatment Consent * I have read and agree to the IPL Consent. Laser: IPL Treatment Instructions * I have read the IPL Pre-Treatment Instructions and IPL Post Treatment Instructions. Laser: Hair Removal Treatment Consent * I have read and agree to the EpiLaze Hair Removal Consent and Dioded Hair Removal Consent 2022. Laser: Hair Removal Treatment Instructions * I have read the Hair Removal Pre-Treatment Instructions 2022 and Hair Removal Post Treatment Instructions 2022. Laser: Erbium Yag Skin Resurfacing Consent * I have read and agree to the Erbium Consent Form. Laser: Erbium Yag Skin Resurfacing Instructions * I have read the Erbium Yag Pre-Procedure Instructions and Erbium Yag Post Procedure Instructions. Laser: Long Pulsed Yag Vascular Reduction Consent * I have read and agree to the Long Pulsed Yag Vascular Reduction Consent. Laser: Long Pulsed Yag Vascular Reduction Instructions * I have read the Laser Vascular Reduction Pre-Treatment Instructions and Laser Vascular Reduction Post Treatment Instructions. Laser: Tattoo Removal Treatment Instructions * I have read the Laser Tatoo Removal Pre-Treatment Instructions. Skin Type Worksheet * I have downloaded the Skin Type Worksheet and will print, complete, and bring it with me to my appointment. Welcome Letter * I have read the Welcome Letter. If you are human, leave this field blank. Next
