Pre Booking Form

Please fill out this form carefully, ticking all the relevant boxes!

Question
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yes
  • Are you under 18?
  • Are you currently pregnant or breastfeeding?
  • Do you suffer from Keloid or Hypertrophic scarring?
  • Have you had botox in this area in the last 2 weeks
  • *Are you taking Anti-Coagulation medication?
  • Have you currently got an outbreak of Herpes? (Cold sores)
  • Do you suffer with severe Acne (vulgaris or rosacea)?
  • Have you had Chemotherapy within the past 6 months?
  • Do you suffer from auto-immune disease?
  • Been diagnosed with any of the following diseases / conditions

  • HIV, AIDS
  • Hepatitis (currently or in the past)
  • Bleeding disorders eg: Hemophilia A or B, Sickle Cell
  • Severe Allergies
  • Cancer
  • Vitiligo
  • Psoriasis, Eczema, Severe Dermatitis (in the area being treated eg: Brows)
  • * Diabetes type 1
  • * Blood pressure problems
  • * Heart problems
  • * Epilepsy
  • *DOCTORS APPROVAL AND LETTER OF CONSENT ARE REQUIRED

Precare advice

Stop using products with retinol (anti-ageing creams) for several weeks before your treatment. Do not take vitamin supplements 3 days before your treatment including Omega 3, Vitamin A and E. These supplements can thin the blood and cause permanent make up to migrate and cause you to bruise. Do not take any pain relief or anti-inflammatories 3 days before. No alcohol from the evening before and no exercise or caffeine on the day of your procedure.

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