Medical Aesthetics Bar

Venus Versa IPL & Nanofractional RF — Consultation & Consent Form

Client Information

Treatment Description — Venus Versa IPL & Nanofractional RF

Venus Versa IPL (Intense Pulsed Light):

• Reduces pigmentation, sun spots, and redness

• Treats vascular lesions and improves overall skin tone

• Stimulates collagen production for firmer, healthier-looking skin

Nanofractional RF (Radiofrequency):

• Delivers micro-needling with radiofrequency energy to the skin

• Reduces fine lines, wrinkles, scars, and stretch marks

• Tightens skin and improves texture and elasticity

• Stimulates collagen and elastin production for long-term rejuvenation

Combined Treatment Benefits:

• Improved skin texture and tone

• Reduced pigmentation and fine lines

• Enhanced skin elasticity and firmness

• Overall rejuvenated, refreshed appearance

Pre-Treatment Instructions

1. Avoid tanning, sun exposure, or self-tanning products for at least 2 weeks prior.

2. Avoid Retinol, chemical peels, or exfoliating treatments for 3–5 days prior.

3. Disclose all medications, allergies, medical conditions, or recent cosmetic procedures.

4. Avoid waxing or hair removal in the treatment area 3–5 days prior.

5. Arrive with a clean face or treatment area, free of makeup, lotions, or oils.

Post-Treatment Instructions

1. Mild redness, swelling, or tenderness may occur and usually resolves within 24–72 hours.

2. Avoid direct sun exposure; use broad-spectrum SPF 30+ on treated areas.

3. Avoid harsh skincare products (retinol, acids, scrubs) for 3–5 days.

4. Do not pick or scratch treated areas to prevent irritation or pigmentation changes.

5. Keep skin hydrated and follow any post-care regimen provided by your provider.

6. Avoid saunas, steam rooms, or intense heat exposure for 24–48 hours.

7. Attend all recommended follow-up sessions to maximize results.

Consent & Liability Acknowledgment

I, the undersigned, acknowledge and agree that:

1. I am voluntarily receiving Venus Versa IPL & Nanofractional RF treatment at Medical Aesthetics Bar and fully understand its nature, purpose, and potential risks.

2. I have provided complete and accurate medical history, including allergies, medications, implants, previous surgeries, or history of cancer.

3. Results vary by individual, and no guarantees or warranties are made regarding outcomes.

4. I have read, understood, and agree to follow all pre- and post-treatment instructions.

5. I release, indemnify, and hold harmless Medical Aesthetics Bar, its owners, employees, and contractors from any liability, claims, or damages arising from the treatment, except in cases of gross negligence or willful misconduct.

6. Photographs may be taken for documentation, treatment comparison, or educational purposes, with my consent while maintaining confidentiality unless otherwise authorized.

7. I will notify Medical Aesthetics Bar immediately if I experience unexpected complications or concerns.

Acknowledgment: