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Consent Signed & Pictures Obtained
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Photo
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Photo
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Photo
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Photo
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Patient numbed for 30 minutes with topical cream
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Face cleansed and prepped with alcohol prior to starting procedure
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Microneedling device used
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Treatment areas
• • •
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Voltage
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Pulse Duration
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Pattern
• • •
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Number of Passes
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Comments
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Response
• • •
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Custom Treatment Plan Recommendations
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Staff to Complete Procedure
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Follow-Up:
• • •
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Follow Up Appointment Reminder
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Care Instructions
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