Well Women's Clinics, 130 Rostrevor St, Hamilton 3204
0-7-838 3400
Name*:
C02 Fractional Laser - Smartide Touch
Practitioner:NaylinSandieDebbieCarole
Fitzpatrick Skin Type:IIIIIIIVVVI
TREATMENT SITE & RECORDED PARAMETRES
Site:
Power:
Dwelling Time:
Spacing:
Stacking:
Pulse Shape:
Anesthetic used:
Before and after photos taken:YesNo
Endpoint & Post Care:Mild erythemaBleedingPost care lotion appliedAdvised post care instructions
Booked follow up review:2 weeks4 weeks6 weeksWhen Required
Post care instructions:Print outEmailed
Other notes:
Name*
Email*
Phone Number*
Age*
Procedure of Interest (Choose other if not listed)*---Skin RejuvenationAcne ScarringSkin PigmentationNeck & Decolletage RejuvenationScarringStretch MarksDeep Lines & WrinklesFacial RhytidesOther
Additional Interest
Email Address*
Well Women's Clinics, 130 Rostrevor St, Hamilton 3204
0-7-838 3400
Well Women's Clinics, 130 Rostrevor St, Hamilton 3204