Get Medical History Form - Lily Med Spa

Completing the Medical History Form is an essential step to ensure you receive the most suitable laser treatment at Lily Med Spa. This guide will help you understand each section of the form for accurate and efficient online submission.

Follow the steps to complete the Medical History Form effectively.

1. Press the ‘Get Form’ button to access the Medical History Form and open it in the editor.
2. Begin by filling in your personal information, including your name, today's date, date of birth, age, occupation, and home address. Ensure that you provide accurate contact details for effective communication.
3. Indicate how you were referred to the spa and select your skin type from the provided list. Circle the number corresponding to your skin type to help the team understand your skin's characteristics.
4. In the medical history section, specify whether you are currently under the care of a physician or a dermatologist. If yes, provide details regarding the medical concerns for which you are receiving care.
5. Check any of the medical conditions that apply to you. This is crucial for the technicians to ensure your safety and customize your treatment.
6. List any other health problems or medical conditions you may have, and provide information about any allergic reactions to specified substances.
7. Detail the oral medications you are currently taking, including any mood-altering or anti-depression medications. Then, indicate if you have used or and provide information about any topical medications or herbal supplements.
8. Complete the history section by specifying if you have had laser hair removal or if you have used any hair removal methods in the past six weeks.
9. Answer questions regarding recent tanning, skin exposure, and your experience with scarring, hyperpigmentation, or hypopigmentation.
10. For individuals who identify as female, answer the questions regarding pregnancy, contraception, and breastfeeding status.
11. Upon completing the form, certify that all provided information is accurate by signing and dating the document. Ensure your signature affirms your responsibility to communicate any changes in your medical history.
12. Finally, save any changes made to the form. You can download, print, or share the completed Medical History Form as needed.

Complete your Medical History Form online today to facilitate your visit at Lily Med Spa.