Online micro needling consultation and consent form Micro needling consultation and consent form Micro needling is a cosmetic procedure that dermatologists use to encourage collagen production by taking advantage of the body’s natural healing response. The purpose of this treatment is to generate new collagen, skin tissue and to smooth, firm, and tone skin. Micro needling is mostly used on the face and may reduce the appearance of acne, scars, dark spots, wrinkles, and large pores. Each session may last about 30 minutes. You may need multiple treatments for the best results. After the procedure the skin will be red and flushed in appearance similar to a moderate sunburn. You will experience a feeling of tightness and possibly a mild irritation of the skin that will diminish over the next few hours. It is not common but occasionally mild bruising can occur depending on the depth the needles being used. Peeling and dry skin is common for up to a week after the treatment as the skin cells are turning over. Very rarely clients will experience minimal scabbing. Please answer all questions. How did you hear about us? Full Name Date of Birth Address Contact Number Email Do you have any of the following contraindication Active infection- viral/fungal/bacterial YesNo Rash on the treatment area YesNo Skin cancer YesNo Active acne YesNo Skin related autoimmune disorder YesNo Blood thinner Prescription YesNo Rosacea YesNo Recent cosmetic injections YesNo Are you pregnant or breast feeding YesNo I understand that results may vary between individuals. I understand that although I may see a change after my first treatment, I may require a series of sessions to obtain my desired outcome I agree that I have read and understand this consent form and all the information above. I understand that this procedure is purely elective. This form is filled in by: Send SimplyTeeth Essex is featured in several media covers. Read more.