| Fraxel#1 |  | 
| Treatment # and Date: | Treatment Location: | 
| Wavelength (nm): | Energy (mJ): | 
| Treatment Level (Total Coverage): | # of Passes Done/# of Passes Device Set to: | 
| Total Energy Delivered (kJ): |  | 
| Fraxel#2 |  | 
| Treatment # and Date: | Treatment Location: | 
| Wavelength (nm): | Energy (mJ): | 
| Treatment Level (Total Coverage): | # of Passes Done/# of Passes Device Set to: | 
| Total Energy Delivered (kJ): |  | 
| Fraxel#3 |  | 
| Treatment # and Date: | Treatment Location: | 
| Wavelength (nm): | Energy (mJ): | 
| Treatment Level (Total Coverage): | # of Passes Done/# of Passes Device Set to: | 
| Total Energy Delivered (kJ): |  | 

