Fitzpatrick Skin Type
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Consent Signed
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Treatment Number:
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Any changes to medical history since last visit:
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Location 1:
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Laser:
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Settings:
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Location 2:
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Laser and settings:
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Settings:
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Notes:
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Photo
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Eye protection on patient throughout treatment:
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Post Treatment Instructions:
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Response:
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Complications:
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Erythema
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Follow-Up:
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Post Treatment Care:
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