TR BEAUTY SPA Official Page

Select Treatment Type

Hair Removal

Photo Rejuvenation (Skin tightening, texture improvement)

Hyperpigmentation (Freckle, Dark Spot)

Vascular Lesions (Broken capillaries, redness)

Acne

Client Information

Full Name

Phone Number

Date of Birth

Technician

Date of Treatment

Treatment Description

Intense Pulsed Light (IPL) is a non-invasive treatment that uses broad-spectrum light to target various skin concerns such as hair follicles, pigmentation, vascular lesions, and acne. The light penetrates below the skin's surface to treat imperfections and stimulate collagen production. A series of treatments may be needed for optimal results.

Medical History

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

Pregnancy or breastfeeding

History of keloids or abnormal scarring

Use of Accutane in the past 6 months

Skin conditions (eczema, psoriasis, herpes simplex)

Photosensitivity or use of light-sensitizing medications

Bleeding disorders or use of anticoagulants

Recent sun exposure, tanning, or waxing in treatment area

Risks & Side Effects

I understand that while IPL treatments are safe and effective, possible side effects include:

Redness, swelling, or sensitivity
Itchiness or irritation
Temporary darkening of spots or light crusting
Hyperpigmentation or hypopigmentation
Burns, blistering, or scarring (rare)
Acne flare-up (for acne treatment)

Before & Aftercare Instructions

**Before Treatment:**

Shave the treatment area 24 hours before your session (for hair removal)
Avoid tanning, waxing, or chemical peels 2 weeks before treatment
Discontinue use of Retinol or photosensitizing products 3-5 days prior
Ensure the treatment area is clean, dry, and free from lotions or deodorant

**After Treatment:**

Avoid direct sun exposure and apply SPF 30+ daily
Do not pick, rub, or scratch treated skin
Avoid heat, saunas, and intense activity for 24-48 hours
Do not wax or pluck hair during IPL hair removal course
Avoid biotin supplements or hair growth stimulants during treatment period

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 the information I provided is accurate.
I understand the treatment, risks, and post-care requirements.
I release TR BEAUTY SPA and staff from any liability due to reactions caused by undisclosed conditions or failure to follow instructions.
I understand that no refunds will be issued for treatments already completed.
I acknowledge that stopping treatment midway may affect results and no guarantees are made.
I have read this form thoroughly, had an opportunity to ask questions, and agree voluntarily to proceed.

By signing below, I confirm that I have read and understood the information provided, and I willingly consent to undergo the specified Laser IPL 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
Session 11
Session 12
Session 13
Session 14
Session 15

Laser IPL Treatment

CLIENT INTAKE FORM