Get Dermapen Consent Form
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How to fill out the Dermapen Consent Form online
Filling out the Dermapen Consent Form online is an essential step to ensure you are fully informed about the treatment and its implications. This guide will lead you through each section of the form, making the process straightforward and clear.
Follow the steps to complete the Dermapen Consent Form.
- Click the ‘Get Form’ button to obtain the Dermapen Consent Form and open it in your editing platform.
- Begin by entering your personal information in the designated fields. In the 'Patient Name (PRINT)' section, input your full name clearly. Follow by entering your 'Address', 'Email', and 'Phone' number to ensure the clinic can contact you easily.
- Read the introductory note addressed to patients. It outlines the importance of being informed about your skin condition and the treatment. Acknowledge this by confirming your understanding of the information provided.
- In the next section, you will indicate your name and the reason for seeking the Dermapen treatment. Clearly state your intentions related to improving facial expression lines and/or skin texture. This helps in personalizing your treatment plan.
- Review the section detailing risks and side effects associated with the procedure. Acknowledge your understanding that side effects may include erythema, bleeding, dryness, and discomfort. Ensure you are comfortable with this information before proceeding.
- Provide your consent by signing your name in the 'Patient’s Signature' field and dating it appropriately. Ensure that your signature matches your printed name.
- The operator will sign the form in the designated area. You may need to wait for their signature if this is not completed at the same time.
- If you consent to the photography and video release, fill in your name and sign the photography section. Read the permissions carefully regarding the use of your images for marketing and educational purposes.
- Decide if you wish to opt-out of having your photos used for marketing purposes. If so, sign and date in the designated area.
- Once all sections are completed, review the form for accuracy. Ensure all information is correct, then save your changes, download the completed form, print it, or share it as needed.
Complete your Dermapen Consent Form online today for a smooth and informed treatment experience.
Medical-Grade Skin Needling (Dermapen) is suitable for most people, if you have severe acne we may suggest starting on other treatments first.
Fill Dermapen Consent Form
I consent to this procedure today and for all subsequent treatments. This form is an example only. This disclosure is not to alarm you but to better inform you so that you may withhold your consent for this treatment. Description of the Procedure. DERMAPEN MICRO-NEEDLING MEDICAL CONSENT FORM. Please complete all questions as accurately as possible. Institute of Dermal Science Academy Dublin Academy 43 Fashion City, Ballymount, Dublin 24 D24 RN12 Contact T: 01 5158442 077151585332154 Depending on the area of your face or body being treated and the type of device used (i.e. Needle length), the procedure is well-tolerated and in some cases.
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