hydrafacial keravive treatment checklist

Hydrafacial Keravive Treatment Checklist

Patient Name:

Date:

History

• Medication (Reacuttane)

• Botox (Migraine)

• PRP

• Thread lift

• Psoriasis

• Eczema

• Hyperthyroidism

• Diabetes

• Epilepsy

• Migraine

• Pregnancy

• Metal Implant

• Active acne

• Allergy

• Previous head surgery

• Post hair transplant

• Open lesions

• Skin cancer

• Allergy

Patient Signature:

Technician: