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Smooth Exposure
Free Consultation Form
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You can eliminate some of the paperwork at your first appointment by answering the questions below before submitting your request for a consultation appointment. If you're in a hurry, just click "Submit" at the bottom of this page with only the information you've completed above and we'll contact you with some appointment options.
Eye Color:
Blue, Gray or Green
Brown
Brownish Black
Hair Color:
Blond
Sandy Red
Chestnut or Dark Blond
Brown
Dark Brown
Black
Skin Color:
Reddish
Very Pale
Pale with a beige tint
Light Brown
Dark Brown
Freckles:
Many
Some
A few
None
Ethnicity:
Caucasian-European
Asian
Indian
Middle-Eastern
African
Mixed
Other
Desired Treatment Type:
Hair removal
Remove age spots/sun damage
Rosacea/spider-veins
Acne
(may check more than one)
Smoother/younger-looking skin
Botox/Dysport/Dermal Fillers
Other
Desired Treatment Area:
Face
Neck
Chest
Back
Arms
Full Legs
Lower Legs
(may check more than one)
Hands
Bikini Line
Underarms
Stomach
Shoulders
Other
How did you hear about Smooth Exposure?
Received Mail
Internet
Friend
Radio
Television
Road Signs
My Hair Salon
My Fitness Center
Newspaper
Magazine
Other
The last time I received significant sun exposure (more than 30 minutes) on my desired treatment area was:
Within the last week
2 weeks ago
A month ago
2 to 3 months ago
More than 3 months
I have already made an appointment:
No
Yes
Please read the following details about the treatment regimen and then click the SUBMIT button at the bottom of the page.
Photo-sensitizing medications, recent exposure to the sun and some herbal supplements tend to magnify the effects of intense pulse light (IPL) and laser system - you may be asked to temporarily discontinue these before and after treatment. It is very important that you discuss your medical history, to include all medications and sun exposure, to the Smooth Exposure staff. It is very important, if you are outside for any significant period of time when your treatment area is exposed to the sun, to liberally apply sun-block to your skin 4 weeks prior to treatment and throughout the entire treatment program.
For laser hair removal, it is important that you cleanly shave the areas intended for treatment the day before your appointment (not the day of your appointment). Following treatment, you can expect some redness - not unlike mild sunburn - that last for a couple of hours. Within a couple of days your body will expel dead hair follicles - this is a natural process that you may notice particularly if the treatment area is large. This is not re-growth; it is a natural result of a successful treatment where the body is expelling dead hair follicles.
Please refrain from waxing, plucking or bleaching between treatments, although showing is acceptable. Waxing and plucking hair in the treatment area will make it much more difficult for the laser treatment to kill the hair follicle. It is critical that the laser be applied to the hair during its active growth cycle in order to kill it. That is not possible if the hair has recently been pulled out.
The laser hair removal systems used by Smooth Exposure are cleared by the FDA to treat all skin types, including the very darkest skin types. However, the risk of burning and reverse pigmentation is increased with darker skin types and tanned skin. Therefore, we treat these skin types more conservatively (multiple treatments at gentler settings) and may have to deny treatment to some patients with darkly pigmented or tanned skin.
The pulsed light system, used for skin rejuvenation, treats skin types I through IV. Unfortunately, we cannot perform skin rejuvenation treatments on clients with either tanned skin or skin type VI.
As a matter of precaution,
Smooth Exposure
enforces the following rules:
-
Smooth Exposure
will not treat recently tanned skin
- darkly pigmented skin types may require a test prior to scheduling an appointment for treatment
- jewerly, including body piercing jewerly, must be removed from target area
- treatment may be denied for specific medical contingencies including pregnancy
- photo-sensitizing drugs, including certain antibiotics, must be temporarily discontinued
- you must commit to avoiding the sun and using sun-block before and after procedures
I have read all of the information on the form and the information I have provided is true and accurate to the best of my knowledge.
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