Free templateFacial
Facial consent form
A complete, professional facial consent and medical history form. Free to download and print - or switch it on inside Lumela and it is created for you, live, in about a minute.
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Don't start from a blank form
You do not have to recreate any of this. Choose facial when you sign up and this exact form appears in your account, ready to send.
What to check before you treat
These are the answers that change whether the appointment goes ahead. The digital version turns the submission red automatically.
- StopHave you taken isotretinoin (Accutane) in the last 6 months?Skin stays fragile for months after the last dose.
- CheckDo you use retinol, tretinoin or another retinoid on this area?Including prescription creams and strong over-the-counter serums.
- StopHave you had Botox or fillers in this area in the last 2 weeks?
- CheckDo you have eczema, psoriasis, rosacea or active breakouts on this area?
- CheckDo you get cold sores?Work near the lips can trigger an outbreak.
- CheckAre you pregnant or breastfeeding?
- CheckDo you have a condition, or take medication, that affects healing or immunity?
What the form covers
Template wording is a professional starting point, not legal advice. Have your attorney review it for your state.
Paper works. Until it does not.
A printed form has to be filled in at the appointment, filed somewhere, and found again years later. It cannot flag a contraindication, cannot prove when it was signed, and cannot email the aftercare. The same form, sent as a link, does all three.
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A complete, printable template written for this treatment. No card, no trial, just the form.
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