My Skin Plasma
I understand that my specialist technician will be in direct contact with me in relation to the Plasma Pen treatment. This treatment involves the use of disposables. All equipment is sterilized before use, all surfaces involved in the process are protected, gloves will be worn at all times and my Plasma Pen Technician will look to use medical asepsis conditions and no- touch technique throughout. In the UK, my specialist will follow guidelines as outlined in section 15 of the Local Government Act 1982 and any other legislation relevant elsewhere. I hereby give written consent to the specialist, who is a fully trained and insured Plasma Pen technician, to carry out the treatment of my choice as requested by me. I have observed that the device being used is a genuine and branded Plasma Pen by Louise Walsh International device.
For your safety and the delivery of a professional treatment, it is absolutely essential that you answer all of the following questions accurately. Please note that answering positively or negatively to many of the questions will not necessarily prevent treatment – it may simply mean your technician will follow specific best practice. If you suffer from any of the conditions listed then it is very important therefore that you notify your specialist so that they can take all the necessary precautions to ensure you receive the best Plasma Pen treatment and avoid any potential risks to your health or well-being:
Do you or have you ever suffered an allergic reaction to any local/topical anaesthetics such as Benzocaine, Lidocaine, Tetracaine or epinephrine?
Medicines, Medical Treatment & Medical Conditions
Are you currently taking any medication or supplements? If so, please list what you are taking and for what condition. This should include any remedies that you
