Get Laser Client Information And Medical History In Order To Provide You With The Most Appropriate

Completing the Laser Client Information and Medical History form is essential for receiving the best laser hair removal or skin care treatment tailored to your needs. This guide provides you with clear, step-by-step instructions to help you fill out the form accurately and efficiently. Your information will be kept strictly confidential.

Follow the steps to fill out the form accurately and completely.

1. Press the ‘Get Form’ button to access the form and open it in your preferred document editor.
2. Begin by filling out your personal history, which includes your full name, today's date, date of birth, age, occupation, and contact information such as your home and work phone numbers.
3. Provide the emergency contact details, including their name and phone number, and indicate how you were referred to the clinic.
4. Select your skin type by circling the appropriate number from the provided options, which range from I (always burns, never tans) to VI (black skin).
5. In the medical history section, indicate whether you are currently under the care of a physician or dermatologist by checking 'yes' or 'no'. Respond to additional health-related questions about previous conditions or medications you are on.
6. List any other health problems and specify the oral and topical medications you are taking, including any past use of .
7. Answer questions regarding previous hair removal methods you have used within the last six weeks and any tanning or skin color changes.
8. If applicable, female users should answer questions related to pregnancy, contraception, and breastfeeding status.
9. In the allergies section, check all listed items you have had reactions to and describe those reactions.
10. By signing at the end of the form, you confirm that all information provided is accurate and acknowledge your responsibility to keep the medical history updated.
11. Once all fields are filled, review your responses for accuracy. You may then save your changes, download, print, or share the completed form as needed.

Take the next step towards your treatment by filling out the Laser Client Information and Medical History form online.