Jessner's Peel Treatment Goal
|
If other please specify
|
Facial Cleanser used
|
Type and % of Jessner's Solution used
|
Skin prepped with Alcohol after cleanse
|
Jessner's Solution applied with
|
Used recommended number of Passes (1-3)
|
|
Treated outside the Recommended number of passes
|
|
Reason
|
Number of Passes
|
Response
• • •
|
|
Did any complications occurred with this treatment
|
Describe the complication, and actions taken to treat it
|
Additional Notes
|
|
Follow up Recommendations
• • •
|
Follow-up for what date? (mm/yy)
/
|