This is an Electrolysis Health History Form that must be filled out before your first electroylisis visit with The Primping Place.
Acknowledgement Of Information (please initial each paragraph)
I understand health history information is important to the Electrologist in order to provide me with safe and effective electrology treatments. I acknowledge all information given by me is accurate to the best of my knowledge and I agree to update my health history assessment whenever there are changes.
I understand that a series of treatments is necessary to achieve permanent hair removal based on my previous temporary methods of hair removal, the science of electrology, and my individual physiological factors.
I have been advised of the post-treatment healing process; the possible risks related to treatment, I agree to follow all aftercare instructions and to notify the Electrologist of any concerns or difficulty in healing.
Please give us a 4 hour notice or you will be charged a $25 no-show fee.
March 20, 2019