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Client Health History: Light-Emitting Diode (LED) Therapy

Client Health History: Light-Emitting Diode (LED) Therapy

Client Health History: Light-Emitting Diode (LED) Therapy

  • Emergency Contact Information

  • Health History

  • These questions are relevant to your skin health and may be contraindications for .
    Please answer thoroughly.
  • Informed Consent

  • Although every precaution will be taken to ensure your safety and wellbeing before, during, and after your LED treatment, please be aware of the following information and possible risks. Please initial.
  • I understand that if I have any concerns, I will address these with my skin care specialist. I give permission to my skin care specialist to perform the LED procedure we have discusses, and will hold him/her and his/her staff harmless and nameless from any liability that may result from this treatment. I have accurately answered the questions above, including all known allergies, prescription drugs, conditions, or products I am currently ingesting or using topically. I understand my skin care specialist will take every precaution to minimize or eliminate negative reactions as much as possible. In the event I may have additional questions or concerns regarding my treatment, I will consult the skin care specialist immediately. I agree that this constitutes full disclosure, and that it supersedes any previous verbal or written disclosures. I certify that I have read, and fully understand, the above paragraphs and that i Have had sufficient opportunity for discussion to have my questions answered. I understand the procedure and accept the risks. I do not hold the skin care specialist, whose signature appears below, responsible for any of my conditions that were present, but not disclosed at the time of this procedure, which may be affected by the treatment performed today.