» CO2 Fractional Laser Treatment Form

CO2 Fractional Laser Treatment

CLIENT INTAKE FORM

Client Information

Treatment Description

I, the undersigned, understand that I am undergoing a CO2 Fractional Laser treatment to improve skin texture, reduce acne scars, wrinkles, and pigmentation. This procedure delivers microscopic columns of laser energy into the skin to stimulate collagen production and skin renewal. Multiple sessions may be required for optimal results.

Medical History

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

Risks & Side Effects

I understand that while CO2 Fractional Laser treatment is generally safe, possible side effects include:

  • Redness, swelling, or discomfort
  • Peeling, dryness, or crusting during healing
  • Hyperpigmentation or hypopigmentation
  • Risk of infection or scarring (rare)
  • Flare-ups of cold sores if prone

Client Responsibilities & Aftercare

I agree to follow all post-treatment instructions:

  • Avoid sun exposure and wear SPF 30+ after healing
  • Use only recommended gentle skincare products
  • Keep the area clean and moisturized
  • Do not pick, peel, or scratch the skin

I understand that downtime may vary between 3-10 days depending on treatment depth.

Photo/Media Consent

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

Consent & Release

  • I confirm that all provided information is accurate.
  • I understand the nature, risks, and alternatives of this treatment.
  • I release TR BEAUTY SPA and staff from liability for any adverse outcomes if aftercare is not followed or health conditions were undisclosed.
  • I understand no guarantees are made regarding results.

By signing below, I confirm that I have read and understood the information provided, and I willingly consent to undergo the specified CO2 Fractional Laser treatment at TR.beautyspa.

Client Signature

Please sign in the box below
loading icon

Processing request...
Please wait and do not close the window!