The Free Treatment has been carried out by the independent company Ellesa Skin Care LTD Company Registration Number 10458176, 6 Colwick Rd NG2 4BU, 00441159338794, firstname.lastname@example.org
Your Treatment is being carried out free of charge. It is up to you to use this treatment as a patch test or we can carry out the full treatment as usual. Please bear in mind that it is always advisable to carry out a patch test and wait for the results and only then you can carry out the full treatment. However you can opt for carrying out the full treatment. If you do not request the patch test we will carry out the full treatment you request straightaway.
Your before pictures as well as, your video and your after pictures will be published for educational and/or marketing purposes and you agree to have these published without any monetary compensation to yourself. If you do not agree to this please refrain from undergoing the free treatment.
- The pictures of the treated area taken daily for 10 days after the treatment. You are encouraged to send us these pictures every day so that we can appraise your healing progression day bay day. Do not simply group all the pictures and send them all at once after the ten days. You can take these pictures yourself using an ordinary mobile phone. For best results you can use the high-definition camera on the mobile itself.
- The pictures of the treated area 14 days after the treatment.
- The pictures of the treated area 1 month After the treatment.
- The pictures of the treated area 2 months after the treatment.
It is important you send us these pictures because this process will help us apprise your healing progression and spot things that may not be quite right early on. Please note that no medical advise is provided.
You can send the pictures of the treated area:
- Via Email attachment to: email@example.com
- Via whatsapp: 0044 7830 885825
Please note that all the treatments using plasma devices can have potential adverse reactions even if the treatment was carried our correctly therefore it important you understand them prior to undergoing any treatments. Therefore please take your time to review the standard consent form and ask any questions you may have. Once you have decided to undergo the treatment it is assumed you understand all the potential adverse reactions and you are happy to undergo the treatment on these bases.
Informed consent from please read carefully
I confirm that I am over 18 and under 65 and that I have been advised of the following:
- The ‘BeautyTeck’ is an aesthetic device. This device is not intended to treat any disease or medical condition. Only benign skin lesions removal can be carried out for aesthetic reasons only. The aesthetic practitioner may not be able to make any diagnosis or assessment of the skin lesion, you intend to have removed, as being benign. It is assumed you already had a formal diagnosis of the lesion you intend to have removed with the device. Benign Moles and benign skin Lesion removal can only be undertaken if the client has had confirmation from their specialist that these are benign. By signing this document you confirm you already sought medical attention in connection with the lesion (or lesions) you want to have removed and it has been diagnosed as a benign skin lesion which you can have removed for aesthetic reasons.
- When removing benign lesions there is always a low risk of hypertophic or atrophic scarring as well as hypo or hyper pigmentation which could develop after healing. These risks can be minimised but never eliminated. You understand that no warranty can be made by the Beauty Therapist/the operator of the device or any other party that after healing none of the above will not develop. Please be aware that certain benign skin lesions may recur despite the method used to remove them. In any case, in the unlikely event the lesion, although previously diagnosed as benign has become red, inflamed, or sore it must be assessed by a specialist and its removal, if appropriate, can only be carried out a medical practitioner with suitable instrumentation.
- In case of tattoo or permanent make-up removal treatments these cannot guarantee a seamless disappearance of the tattoo within one session this applies to plasma tattoo removal treatments and permanent make-up removal. Although the likelihood of scarring, hyper-pigmentation, or hypo-pigmentation are very low this always exists despite the method used to perform the treatment. It can be minimised but never completely ruled out. The tattoo removal and permanent makeup treatment involves scabbing and the formation of new skin during the healing process. Therefore the area will have a different skin texture after the scabs have fallen off. This is normal and to be expected. The area usually blend in with the surrounding area over the course of the following weeks. In any case please bear in mind that seamless results cannot be guaranteed after tattoo removal. Infections or early sun exposure during the healing period increases the likelihood of the potential adverse reactions listed above including scarring.
- In Case of Plasma Eyelid Tightening Treatments with the “BeautyTeck” can result in some immediate reactions including redness, major swelling and pain or tenderness. Pain usually lasts up-to 24 hours after the treatment, but sometimes slightly longer. Swelling can last up to five days. If any of these symptoms persist for more than six days, or if any other side effects develop, report them to your beauty practitioner and consult your doctor. Long term redness and slight tenderness may continue for a few weeks following the treatment.
- It is imperative that the aftercare instructions are followed as prescribed to minimise the likelihood of Adverse Reactions.
- There is small risk of scarring, hypo-pigmentation or hyper-pigmentation which can be minimised but can never be completely avoided, however these risks are greatly increased if the aftercare instructions are not strictly adhered to.
- The number of sessions required to achieve the desired result will be determined by the type of treatment you request and the size of the area being treated. The minimum interval between treatments on the same area is 6 weeks. This minimum time period may be extended at discretion of your beauty practitioner, depending on your skin type and your individual reaction to the treatment.
- The likelihood of hyper pigmentation is very low and can be minimised but never completely avoided. Hypo-pigmentation is a normal reaction in skin renewal and normally disappears after a few months. These risks are minimised by following the after-care recommendations and avoiding sun exposure and applying total sun block for the prescribed period.
- Avoid extreme sun exposure, UV light, freezing temperatures and saunas for 2 weeks after treatment.
- The ‘BeautyTeck’ has not been tested on children, breast-feeding or pregnant women and is therefore not recommended in these cases.
- Treatments with the “BeautyTeck” should be avoided if you have an underlying medical condition or you are diabetic.
- The ‘BeautyTeck’ is not recommended to be used on those clients with increased susceptibility to Keloid formation and hyper-trophic scarring.
- IF YOU EVER HAD EPISODES OF HERPES SIMPLEX IT IS RECOMMENDED TO UNDERGO A COMPLETE ANTIVIRAL COURSE TREATMENT BEFORE UNDERGOING ANY TREATMENT WITH THE DEVICE.
- TREATMENTS WITH THE DEVICE ARE NOT RECOMMENDED IF YOU HAVE A PACEMAKER or metal implant.
- Effects of the ‘BeautyTeck’ for simultaneous use with peeling, botox, laser or ultrasound based treatments is unknown and should be avoided for at least two months after the last treatment.
- There is no available data (efficacy, tolerance) about the application of the ‘BeautyTeck’ :-
a) in clients with a previous history of autoimmune diseases or receiving immunotherapy or
b) into an area which has already been treated with a filling product (especially permanent filling materials such as Silicone or Aquamid) unless it is certain that the filling product is no longer present.
c) an area treated with lasers or cosmetic lasers.
- To minimise the risk of infection or undesired effects, including scarring, hyper and hypo pigmentation and other undesired effects, these instructions must be followed.
- Treatments with the ‘BeautyTeck’, can result in some immediate reactions including redness, minor bleeding and swelling. Should minor bleeding appear soon after the treatment this maybe normal. Any swelling can last up to 6 days. If redness persists, there are sign of infections or the part is sore, after 10 days consult your doctor.
- At any point should you have any concern, please consult your beauty Practitioner. Please note that in some cases your beauty practitioner advice must not be interpreted as medical advice. For medical advice always refer to a medical practitioner.
- It is your responsibility to keep the treated area clean and minimise the risks of infection. Apply the appropriate antiseptic product twice a day.
- In the unlikely event an infection arises or the swelling or redness has not subsided within 6 days contact your doctor. A persisting infection can lead to scarring.
- Avoid direct sun exposure, UV light, freezing temperatures and saunas for ten days after treatment. Once the area treated has recovered (scabs fallen off) apply total sunscreen daily for up to 3 months after the last treatment. Sun exposure must be avoided for three months after the treatment even while wearing sunscreen, especially in those areas or the world where the ultraviolet rays are very strong (i.e. tropical and subtropical areas). Do not sunbathe, do not use any tanning products or UV lamps. Failure to do so can increase likelihood of developing hyper-pigmentation.
- Avoid the use of any plasters on the area treated.
- Do not use any cover-up make-up or any make-up of any kind up until the scabs (which may form) have fallen off by themselves and the area has recovered fully. The use of any type of make-up while the area is still recovering can increase the risks of scar formation and hypo-pigmentation.
- Do not use any creams of any type on the area treated. Avoid the use of antibiotic products and antibiotic creams in order to prevent infections. Antibiotic creams or products should only be used to cure certain types of infections and must not be used as standard after-care after this type of aesthetic procedures.
- Do not use any product not expressedly recommended in writing by your beauty therapist.
- Avoid exercise, smoking and alcohol consumption for one day following treatment and extreme sports until the part treated has fully recovered.
- Avoid any activity which may increase the risks of infection.
- Do not pick the any scabs which may follow the aesthetic treatment.
- It is recommended to take pictures daily until the area has healed completely and submit them to firstname.lastname@example.org to monitor the skin recovery process. If we are unable to monitor the healing process we cannot advise you on the corrective actions on time, should there be some abnormal reactions or infections. Being able to address the issue during healing will help prevent long term adverse reactions.
The aesthetic practitioner has:
- Provided me with sufficient information about the treatment in order to make an informed decision,and I understand the risks involved. I understand that if I do not want to take those risks I can simply abstain from any treatment with the device.
- Given me the opportunity to ask all questions I may have about the treatments, has answered them to the best of their ability and I have understood the answers.
- Provided sufficient time to consider whether I want to undergo the aesthetic treatment.
These treatments are carried out free of charge. Please note that in rare instances these treatments can lead to hypertrophc scars, atrophic scars, hyper-pigmentation and skin laxity on the upper eyelid. These risks can be minimised however never completely avoided due to the nature of the treatment. You release the company performing the treatment and any associates from any losses or liability arising from such events.
Your Name [swift_name size=”medium”]
Signed on this [swift_date_long].
Primary Email: [swift_email name=”email” required] [swift_button] [/swiftsign]