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Microdermabrasion

Facials Consent Form

Microdermabrasion Facials Consent Form

About Microdermabrasion

The microdermabrasion you will receive is a procedure designed to exfoliate or remove the outer layers of the skin. A diamond-tip wand is used to exfoliate and remove dead skin cells from the outermost layer of the skin. Your skin may be red or have a wind-burned or sunburned look for a few days. Most side effects are temporary and generally subside within 72 hours. Possible (not probable) side effects include and are not limited to, slight redness, extreme redness, swelling, bruising, stinging, tenderness, dry or flaking skin, and lightening or darkening of the skin. In addition, side effects could include slight blood potting which may appear with deeper treatment levels. Healing may take several days or longer. Anytime the skin barrier is broken, there is a small risk of bacterial or viral infection. You must avoid Alpha-Hydoxy acid, Glycolic acid products, Retin-A, Salicylic acid, and skin exfoliation scrubs for 72 hours after treatment.

Skin History

Please check any of the following that apply to you

Emergency Contact

Medical Information


Please check any of the following that apply to you

Skin Care History

Please read carefully and initial beside each statement

Consent & Agreement

By providing my name below, I give my consent and voluntary release to Beauty Oasis from any claims, implied or stated that I have or may have in the future with this treatment, regardless of the result. I agree that I have read and fully understand the possibility of known and unknown risks, complications, and limitations to this treatment. I agree that I do not have any conditions or contraindications that would make this treatment unsuitable for me and I agree to waive all liability towards my technician and Beauty Oasis if the treatment form was filled out incorrectly.

About Microdermabrasion

The microdermabrasion you will receive is a procedure designed to exfoliate or remove the outer layers of the skin. A diamond-tip wand is used to exfoliate and remove dead skin cells from the outermost layer of the skin. Your skin may be red or have a wind-burned or sunburned look for a few days. Most side effects are temporary and generally subside within 72 hours. Possible (not probable) side effects include and are not limited to, slight redness, extreme redness, swelling, bruising, stinging, tenderness, dry or flaking skin, and lightening or darkening of the skin. In addition, side effects could include slight blood potting which may appear with deeper treatment levels. Healing may take several days or longer. Anytime the skin barrier is broken, there is a small risk of bacterial or viral infection. You must avoid Alpha-Hydoxy acid, Glycolic acid products, Retin-A, Salicylic acid, and skin exfoliation scrubs for 72 hours after treatment.

Skin History

Please check any of the following that apply to you

Emergency Contact

Medical Information


Please check any of the following that apply to you

Skin Care History

Please read carefully and initial beside each statement

Consent & Agreement

By providing my name below, I give my consent and voluntary release to Beauty Oasis from any claims, implied or stated that I have or may have in the future with this treatment, regardless of the result. I agree that I have read and fully understand the possibility of known and unknown risks, complications, and limitations to this treatment. I agree that I do not have any conditions or contraindications that would make this treatment unsuitable for me and I agree to waive all liability towards my technician and Beauty Oasis if the treatment form was filled out incorrectly.

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