TR BEAUTY SPA Official Page

Select Treatment Type

Acne Treatment

Chemical Peel

Client Information

Full Name

Phone Number

Date of Birth

Technician

Date of Treatment

Treatment Description

Acne Treatment: May involve cleansing, exfoliation, extraction, LED light, and spot treatment serums to reduce acne and inflammation.

Chemical Peel: Uses professional-grade exfoliating acids to improve skin texture, treat acne scars, reduce pigmentation and boost radiance. Peel depth varies per skin condition.

Extraction Notice:

Manual extraction involves applying pressure to the skin to remove impurities and acne. Temporary redness or swelling may occur after treatment — this is a normal skin reaction.

Clients are advised to avoid makeup, events, or exposure to pollution after the procedure.

Please read carefully before proceeding with the acne treatment. By signing below, you acknowledge and accept the possible side effects.

Medical History

Do you currently have or have had any of the following?

Accutane in the past 6 months

Active cold sores/herpes

Sensitive or broken skin

Allergies to skincare products or acids

Pregnancy/Breastfeeding

Autoimmune disease or immune suppressant use

History of keloids or abnormal scarring

If any are checked, please describe

Risks & Side Effects

Redness, irritation, flaking or peeling
Sensitivity to sun and skincare products
Possible pigmentation changes or acne flare-ups
Risk of allergic reactions or prolonged healing if aftercare is not followed

Client Responsibilities & Aftercare

Avoid sun exposure and always use sunscreen
Do not pick or exfoliate the treated skin
Use recommended products only
Avoid sweating, saunas, or hot showers for 24-48 hours

Photo/Media Consent

I give TR BEAUTY SPA permission to take photos/videos of my treatment area for:

Internal records only

Marketing and educational purposes (social media, website, etc.)

I do NOT consent to any photography

Consent & Release

I confirm all provided information is accurate.
I understand the nature, risks, and expected outcomes of the treatment selected.
I release TR BEAUTY SPA and its staff from liability for any reactions or results due to undisclosed conditions or failure to follow aftercare.
I understand results vary and multiple sessions may be required.

I understand that TR• Beauty Spa is committed to providing safe, professional, and individualized treatments using appropriate techniques and medical-grade technologies. I acknowledge that treatment outcomes vary between individuals and depend on factors beyond the control of TR• Beauty Spa, including my skin condition, medical history, lifestyle, healing response, and compliance with aftercare instructions. Therefore, no specific result or degree of improvement can be guaranteed. I understand that an outcome different from my expectations does not, by itself, indicate negligence or improper treatment. All treatments and packages are Final Sale and non-refundable, except where required by applicable law.

By signing below, I confirm that I have read and understood the information provided, and I willingly consent to undergo the specified acne treatment at TR.beautyspa.

Client Signature

Please sign in the box below

Date

Treatment Session Log

Please fill in the following table with the date and notes for each session.

Session	Date	Notes
Session 1
Session 2
Session 3
Session 4
Session 5
Session 6
Session 7
Session 8
Session 9
Session 10

Acne Treatment / Chemical Peel

CLIENT INTAKE FORM