TR BEAUTY SPA Official Page

Client Information

Full Name

Phone Number

Date of Birth

Technician

Date of Treatment

Treatment Description

I, the undersigned, understand that I am undergoing a non-surgical laser procedure using CO2 technology to remove:

Skin Tags

Moles (non-cancerous)

Milia

Other

The procedure involves ablating superficial skin lesions using a CO2 laser device.

Medical History

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

Cold sores/herpes

Keloid scarring

Diabetes

Pregnant/Breastfeeding

Accutane/Retinol (last 6 months)

Recent tanning/sunburn

Blood thinners

History of skin cancer or abnormal pigmentation

If any are checked, please describe

Risks & Side Effects

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

Redness, swelling, or discomfort
Scabbing or crusting during healing
Temporary pigmentation changes
Minor risk of scarring or infection

Client Responsibilities & Aftercare

I agree to follow all post-treatment instructions:

Avoid sun exposure
Keep area clean and dry
Do not pick or scratch
Apply healing ointment as instructed

I understand healing time and results vary per individual.

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 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.

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 Laser CO2 treatment at TR.beautyspa.

Client Signature

Please sign in the box below

Date

Laser CO2 Treatment