Treatment Settings- ND Yag Form - AllWhite Laser AW3®

Tattoo Removal, Pigmentation Removal, Birthmark Removal, Nevus of Ota, Carbon Facial

Nombre*
Nombre Apellidos
DOB*
Date of Birth

Día
Mes
Año
Teléfono*
Correo electrónico
Address*
Dirección Ciudad Estado / Provincia / Región ZIP / Código Postal País
Treatment Type*
Select a treatment you are having today
Which Patch Test*
Select a patch test type
Treatment Area(s)*
List all treatment areas
Precio*
Price payable for this session
Quotation & Notes*
Quotation and notes regarding the treatments. E.g Quoted customer £200 per session for hand and chest
Consentimiento*
I have been advised on how to care for my skin after the AW3® treatments. I will follow the procedure as advised to me. There has been no changes to my health since my last treatment and I am not taking any new medication.
- Accept Treatment