Thanks for booking your treatment with us!

Currently, are you:

Pregnant?

Breastfeeding?

A smoker?

Have any current chronic or serious medical illnesses such as:

Have any auto-immune diseases such as:

Have any known allergies including topical anaesthetics, nuts and/or metals?

How would you describe your skin?

How would you describe your stress levels?

What skincare products are you currently using?

I give consent for the following treatment, Microneedling / The Million Dollar Facial to be performed by AA BEAUTY. I understand the treatment uses a dermapen device to create micro needle punctures that cause mild trauma to the skin’s surface to stimulate the natural production of new collagen and elastin. I confirm that I understand the risks and conditions associated with Microneedling and that it is an elective procedure. I confirm that all risks have been fully explained to me and I have had the opportunity to ask any questions and these have been answered to my satisfaction.

I understand that there are certain contraindications that would preclude me from receiving treatment including an active bacterial, viral, fungal or herpetic infection, rasied moles or warts, active acne, rosacea, facial cancers, history of radiation therapy within the application area, a history of abnormal scarring, keloids, atrophic skin, autoimmune disorders, haemophiliac, diabetes, taking anticoagulants, pregnant or breastfeeding and being under the age of 18. I accept and understand that there are no written, implied or verbal guarantees as to the anticipated results of this treatment and that the effects of treatment will vary with some patients than with others. The goal is improvement, not perfection.