CLIENT INFORMATION & MEDICAL HISTORY
In order to provide you with the most appropriate laser treatment, we need you to complete the following questionnaire. All information is strictly confidential
I certify that the preceding medical, personal and skin history statements are true and correct. I am aware that it is my responsibility to inform the technician, esthetician, therapist, doctor or nurse of my current medical or health conditions and to update this history. A current medical history is essential for the caregiver to execute appropriate treatment procedures.