Microcurrent Form

Please fill out this form as fully as possible.

  • These questions are relevant to your skin health and may be contraindications for treatment, please answer thoroughly.

  • Check all that apply.
  • Although every precaution will be taken to ensure your safety and wellbeing before, during and after your microcurrent treatment, please be aware of the following information and possible risks.

    By marking 'Yes' you acknowledge your understanding.

Pin It on Pinterest