I duly authorize Canvas Aesthetics (Pty) Ltd to perform the Dermapen™ Microneedling treatment.
I understand that Dermapen™ Microneedling is an approved treatment, designed to create a safe healing response within the body, through the use of surgical microneedles that puncture pinpoint microchannels in the body, igniting natural collagen and elastin production from within the skin and is used for anti-aging, rejuvenation, pigmentation and skin texture of which I hereby consent to be a client receiving the Dermapen™ Microneedling treatment on the specified area above for the specified concern.
I understand that clinical results may vary depending on individual factors, including medical history, skin type, client compliance with pre/post treatment instructions and individual response to treatments.
I confirm that I have informed the staff regarding any current or past medical condition, disease or medication taken and that the list of contraindications has been fully explained to me. I also undertake to inform the staff of any changes to my medical condition or medication taken during the course of my treatment or any further future treatments.
I understand that there is a possibility of temporary Short-Term Effects which have been fully explained to me and that I will inform the staff of any adverse reactions within 24 hours of them occurring:
I have been fully informed and understand:
I confirm and understand that the Pre-Treatment Protocols have been fully explained to me and are important and advisable for the desired outcome and that I undertake to / have adhered to these requirements prior to my treatment.
I confirm and understand that the Post-Treatment Protocols have been fully explained to me and I will adhere to these requirements after my treatment. I also acknowledge and understand that Maintenance and additional Home Care Routines are advisable for effective and long-lasting results.
I understand the importance of Before and After Photographs and consent to the following:
I have read and fully understand the contents of this consent form.