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Face
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Facial Areas Treated
• • •
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Hair Color
• • •
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Hair Type
• • •
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Laser Type
• • •
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Chill tip settings (face)
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Chill Tip Rate
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Chill Tip Pulse Width
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Chill Tip Fluence
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Chill Tip Laser NM
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High Speed Settings (face)
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HS Pulse Stacking
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HS Pulse Width
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HS Vaccum
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HS Fluence
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HS Laser NM
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Chest
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Hair Color
• • •
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Hair Type
• • •
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Laser Type
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Chest Areas Treated
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Chill Tip Settings (chest)
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Chill Tip Rate
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Chill Tip Pulse Width
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Chill Tip Fluence
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Chill Tip Laser NM
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High Speed Settings (chest)
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HS Pulse Stacking
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HS Pulse Width
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HS Vaccum
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HS Fluence
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HS Laser NM
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Back
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Hair Color
• • •
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Hair Type
• • •
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Laser Type
• • •
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Chill Tip Settings (Back)
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Chill Tip Rate
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Chill Tip Pulse Width
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Chill Tip Fluence
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Chill Tip Laser NM
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High Speed Settings (Back)
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HS Pulse Stacking
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HS Pulse Width
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HS Vaccum
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HS Fluence
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HS Laser NM
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Stomach
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Hair Color
• • •
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Hair Type
• • •
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Laser Type
• • •
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Chill Tip Settings (Stomach)
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Chill Tip Rate
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Chill Tip Pulse Width
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Chill Tip Fluence
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Chill Tip Laser NM
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High Speed Settings (Stomach)
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HS Pulse Stacking
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HS Pulse Width
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HS Vaccum
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HS Fluence
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Underarms
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Hair Type
• • •
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Hair Color
• • •
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Laser Type
• • •
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Chill Tip Settings (UA)
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Chill Tip Rate
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Chill Tip Pulse Width
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Chill Tip Fluence
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Chill Tip Laser NM
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High Speed Settings (UA)
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HS Pulse Stacking
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HS Pulse Width
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HS Vaccum
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HS Fluence
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HS Laser NM
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Arms
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Hair Color
• • •
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Hair Type
• • •
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Laser Type
• • •
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Arm Area
• • •
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Chill Tip Settings (arms)
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Chill Tip Rate
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Chill Tip Pulse Width
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Chill Tip Fluence
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Chill Tip Laser NM
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High Speed Settings (arms)
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HS Pulse Stacking
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HS Pulse Width
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HS Vaccum
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HS Fluence
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HS Laser NM
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Bikini / Brazilian
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Hair Color
• • •
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Hair Type
• • •
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Laser Type
• • •
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Brazilian vs Bikini Line
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Chill Tip Settings (Brazilian/bikini)
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Chill Tip Rate
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Chill Tip Fluence
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Chill Tip Pulse Width
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Chill Tip Laser NM
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High Speed Settings (Bikini/Brazilian)
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HS Pulse Stacking
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HS Pulse Width
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HS Vaccum
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HS Fluence
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HS Laser NM
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Legs
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Hair Color
• • •
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Hair Type
• • •
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Laser Type
• • •
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Leg Area
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Chill Tip Settings (Leg)
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Chill Tip Rate
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Chill Tip Pulse Width
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Chill Tip Fluence
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Chill Tip Laser NM
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High Speed Settings (Legs)
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HS Pulse Stacking
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HS Pulse Width
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HS Vaccum
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HS Fluence
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HS Laser NM
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Laser Treatment Performed By
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Additional Treatment Notes
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Post Care Instructions
• • •
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Conversation Notes
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LHR Health History Review
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Pre-Treatment Risk review
• • •
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Do you have (or getting treated for)
• • •
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Are you currently under a doctor's care?
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Do you have any current or chronic medical illnesses?
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Have you taken photosensitizing medication in last 2 weeks? (anti-depressants, St. Johns Wart etc)
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Other Medications
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Do you smoke?
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Do you have have a history of keloid & hypertrophic scar formation?
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Do you have any active infections?
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Do you have any open lesions in the areas to be treated
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History of cold sores/herpes simplex virus?
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Do you have any allergies?
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If yes what kind?
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Have you got any type of skin tan (fake or natural)?
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Any unprotected sun exposure in 2 weeks?
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Do you have permanent makeup or implants?
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When was the last time you had a laser treatment in area being treated? (Month, Day, Year)
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Have you had Laser Resurfacing within the last 6 months?
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Have you had a Chemical Peel in the last 4 weeks
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Have you used used Accutane within the last 6 months
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Have you used retinols within the past 7 days
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Are you pregnant?
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Autoimmune Disorder (Lupus, Vitiligo, Scleroderma)?
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Risks/Benefits Reviewed and questions answered
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