{"id":1216,"date":"2021-02-17T14:45:15","date_gmt":"2021-02-17T19:45:15","guid":{"rendered":"https:\/\/www.lenoxesthetics.com\/?page_id=1216"},"modified":"2022-02-18T03:09:15","modified_gmt":"2022-02-18T08:09:15","slug":"the-perfect-derma-peel-consent","status":"publish","type":"page","link":"https:\/\/www.lenoxesthetics.com\/?page_id=1216","title":{"rendered":"The Perfect Derma Peel Consent"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"1216\" class=\"elementor elementor-1216\">\n\t\t\t\t\t\t<div class=\"elementor-inner\">\n\t\t\t\t<div class=\"elementor-section-wrap\">\n\t\t\t\t\t\t\t\t\t<section data-particle_enable=\"false\" data-particle-mobile-disabled=\"false\" class=\"elementor-section elementor-top-section elementor-element elementor-element-43c5a3e2 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"43c5a3e2\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t\t\t<div class=\"elementor-row\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-1608eb47\" data-id=\"1608eb47\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-column-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-e05e1e4 elementor-widget elementor-widget-shortcode\" data-id=\"e05e1e4\" data-element_type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-shortcode\">\n                <div class='gf_browser_gecko gform_wrapper' id='gform_wrapper_12' ><a id='gf_12' class='gform_anchor' ><\/a><form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_12' id='gform_12'  action='\/index.php?rest_route=%2Fwp%2Fv2%2Fpages%2F1216#gf_12'>\n                        <div class='gform_body'><ul id='gform_fields_12' class='gform_fields top_label form_sublabel_below description_below'><li id='field_12_1'  class='gfield gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible' ><center><img decoding=\"async\" src=\"https:\/\/www.lenoxesthetics.com\/wp-content\/uploads\/2021\/02\/Screenshot-2021-02-18-at-1.12.38-AM.png\"><\/img><\/center><\/li><li id='field_12_2'  class='gfield field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_12_2' ><\/label><div class='ginput_container ginput_container_text'><input name='input_2' id='input_12_2' type='text' value='' class='medium'      aria-invalid=\"false\" \/><\/div><div class='gfield_description'><p>Prior to receiving treatment, I have informed my medical professional about any medications or health conditions that may contraindicate this treatment.<\/p><\/div><\/li><li id='field_12_3'  class='gfield field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_12_3' ><\/label><div class='ginput_container ginput_container_text'><input name='input_3' id='input_12_3' type='text' value='' class='medium'      aria-invalid=\"false\" \/><\/div><div class='gfield_description'><p>I understand that there might be some discomfort such as stinging, redness, burning, itchiness or tightness during and a week after the treatment. I understand that it is important not to pull, pick at or remove peeling\nskin forcibly.<\/p><\/div><\/li><li id='field_12_4'  class='gfield field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_12_4' >I understand that there is no specific guarantee as to the final results of the peel, and that I may require more than one treatment for optimal results.<\/label><div class='ginput_container ginput_container_text'><input name='input_4' id='input_12_4' type='text' value='' class='medium'      aria-invalid=\"false\" \/><\/div><\/li><li id='field_12_5'  class='gfield field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_12_5' ><\/label><div class='ginput_container ginput_container_text'><input name='input_5' id='input_12_5' type='text' value='' class='medium'      aria-invalid=\"false\" \/><\/div><div class='gfield_description'><p> I understand that while complications are extremely rare, they may occur. In the event of a reaction or complication, I agree to immediately contact my medical professional for follow up care.<\/p><\/div><\/li><li id='field_12_6'  class='gfield field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_12_6' ><\/label><div class='ginput_container ginput_container_text'><input name='input_6' id='input_12_6' type='text' value='' class='medium'      aria-invalid=\"false\" \/><\/div><div class='gfield_description'><p>Occasionally hyper pigmentation or hypo pigmentation may develop which can persist for weeks or months after the treatment.<\/p><\/div><\/li><li id='field_12_7'  class='gfield field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_12_7' ><\/label><div class='ginput_container ginput_container_text'><input name='input_7' id='input_12_7' type='text' value='' class='medium'      aria-invalid=\"false\" \/><\/div><div class='gfield_description'><p>I understand that post peel care includes use of Mineral Perfection Tinted SPF 30 or an SPF 30 or above And will avoid sun exposure during the exfoliation process.<\/p>\n<\/div><\/li><li id='field_12_8'  class='gfield field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_12_8' ><\/label><div class='ginput_container ginput_container_text'><input name='input_8' id='input_12_8' type='text' value='' class='medium'      aria-invalid=\"false\" \/><\/div><div class='gfield_description'><p>I understand that extended sun exposure, including use of tanning beds, is prohibited both before and after The Perfect Derma Peel treatment. Avoid sweating excessively or use of steam\/sauna for 3 days post peel.<\/p><\/div><\/li><li id='field_12_9'  class='gfield field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_12_9' ><\/label><div class='ginput_container ginput_container_text'><input name='input_9' id='input_12_9' type='text' value='' class='medium'      aria-invalid=\"false\" \/><\/div><div class='gfield_description'><p>I understand that this is an elective procedure and is nonrefundable.<\/p><\/div><\/li><li id='field_12_10'  class='gfield field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_12_10' ><\/label><div class='ginput_container ginput_container_text'><input name='input_10' id='input_12_10' type='text' value='' class='medium'      aria-invalid=\"false\" \/><\/div><div class='gfield_description'><p>I understand that no other chemical peels or medical device treatments are to be performed on my skin until my medical professional releases me to do so.<\/p><\/div><\/li><li id='field_12_11'  class='gfield field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_12_11' ><\/label><div class='ginput_container ginput_container_text'><input name='input_11' id='input_12_11' type='text' value='' class='medium'      aria-invalid=\"false\" \/><\/div><div class='gfield_description'><p>I authorize the taking of clinical photographs for my medical record, to be used for scientific purposes both in publication and presentations. I understand my identity will be protected.<\/p><\/div><\/li><li id='field_12_12'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_12_12' >Print Name<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_12' id='input_12_12' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\" \/><\/div><\/li><li id='field_12_13'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_12_13' >Date<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_13' id='input_12_13' type='text' value='' class='datepicker medium dmy datepicker_no_icon'   \/>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_12_13' class='gform_hidden' value='https:\/\/www.lenoxesthetics.com\/wp-content\/plugins\/gravityforms\/images\/calendar.png'\/><\/li><li id='field_12_14'  class='gfield gform_validation_container field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_12_14' >Email<\/label><div class='ginput_container'><input name='input_14' id='input_12_14' type='text' value='' \/><\/div><div class='gfield_description'>This field is for validation purposes and should be left unchanged.<\/div><\/li>\n                            <\/ul><\/div>\n        <div class='gform_footer top_label'> <input type='submit' id='gform_submit_button_12' class='gform_button button' value='Submit and Download'  onclick='if(window[\"gf_submitting_12\"]){return false;}  window[\"gf_submitting_12\"]=true;  ' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_12\"]){return false;} window[\"gf_submitting_12\"]=true;  jQuery(\"#gform_12\").trigger(\"submit\",[true]); }' \/> <input type='hidden' name='gform_ajax' value='form_id=12&amp;title=&amp;description=&amp;tabindex=0' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_12' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='12' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_12' value='WyJbXSIsIjIyZDU2NzIwYmQyYmFmNTYxMTU3OTE0YWM2Njk1NTUxIl0=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_target_page_number_12' id='gform_target_page_number_12' value='0' \/>\n            <input type='hidden' class='gform_hidden' name='gform_source_page_number_12' id='gform_source_page_number_12' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            \n        <\/div>\n                        <\/form>\n                        <\/div>\n                <iframe style='display:none;width:0px;height:0px;' src='about:blank' name='gform_ajax_frame_12' id='gform_ajax_frame_12'>This iframe contains the logic required to handle Ajax powered Gravity Forms.<\/iframe>\n                <script type='text\/javascript'>jQuery(document).ready(function($){gformInitSpinner( 12, 'https:\/\/www.lenoxesthetics.com\/wp-content\/plugins\/gravityforms\/images\/spinner.gif' );jQuery('#gform_ajax_frame_12').on('load',function(){var contents = jQuery(this).contents().find('*').html();var is_postback = contents.indexOf('GF_AJAX_POSTBACK') >= 0;if(!is_postback){return;}var form_content = jQuery(this).contents().find('#gform_wrapper_12');var is_confirmation = jQuery(this).contents().find('#gform_confirmation_wrapper_12').length > 0;var is_redirect = contents.indexOf('gformRedirect(){') >= 0;var is_form = form_content.length > 0 && ! is_redirect && ! is_confirmation;if(is_form){jQuery('#gform_wrapper_12').html(form_content.html());if(form_content.hasClass('gform_validation_error')){jQuery('#gform_wrapper_12').addClass('gform_validation_error');} else {jQuery('#gform_wrapper_12').removeClass('gform_validation_error');}setTimeout( function() { \/* delay the scroll by 50 milliseconds to fix a bug in chrome *\/ jQuery(document).scrollTop(jQuery('#gform_wrapper_12').offset().top); }, 50 );if(window['gformInitDatepicker']) {gformInitDatepicker();}if(window['gformInitPriceFields']) {gformInitPriceFields();}var current_page = jQuery('#gform_source_page_number_12').val();gformInitSpinner( 12, 'https:\/\/www.lenoxesthetics.com\/wp-content\/plugins\/gravityforms\/images\/spinner.gif' );jQuery(document).trigger('gform_page_loaded', [12, current_page]);window['gf_submitting_12'] = false;}else if(!is_redirect){var confirmation_content = jQuery(this).contents().find('.GF_AJAX_POSTBACK').html();if(!confirmation_content){confirmation_content = contents;}setTimeout(function(){jQuery('#gform_wrapper_12').replaceWith(confirmation_content);jQuery(document).scrollTop(jQuery('#gf_12').offset().top);jQuery(document).trigger('gform_confirmation_loaded', [12]);window['gf_submitting_12'] = false;}, 50);}else{jQuery('#gform_12').append(contents);if(window['gformRedirect']) {gformRedirect();}}jQuery(document).trigger('gform_post_render', [12, current_page]);} );} );<\/script><script type='text\/javascript'> if(typeof gf_global == 'undefined') var gf_global = {\"gf_currency_config\":{\"name\":\"U.S. Dollar\",\"symbol_left\":\"$\",\"symbol_right\":\"\",\"symbol_padding\":\"\",\"thousand_separator\":\",\",\"decimal_separator\":\".\",\"decimals\":2},\"base_url\":\"https:\\\/\\\/www.lenoxesthetics.com\\\/wp-content\\\/plugins\\\/gravityforms\",\"number_formats\":[],\"spinnerUrl\":\"https:\\\/\\\/www.lenoxesthetics.com\\\/wp-content\\\/plugins\\\/gravityforms\\\/images\\\/spinner.gif\"};jQuery(document).bind('gform_post_render', function(event, formId, currentPage){if(formId == 12) {} } );jQuery(document).bind('gform_post_conditional_logic', function(event, formId, fields, isInit){} );<\/script><script type='text\/javascript'> jQuery(document).ready(function(){jQuery(document).trigger('gform_post_render', [12, 1]) } ); <\/script><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":1071,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-1216","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.lenoxesthetics.com\/index.php?rest_route=\/wp\/v2\/pages\/1216","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.lenoxesthetics.com\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.lenoxesthetics.com\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.lenoxesthetics.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.lenoxesthetics.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1216"}],"version-history":[{"count":4,"href":"https:\/\/www.lenoxesthetics.com\/index.php?rest_route=\/wp\/v2\/pages\/1216\/revisions"}],"predecessor-version":[{"id":1542,"href":"https:\/\/www.lenoxesthetics.com\/index.php?rest_route=\/wp\/v2\/pages\/1216\/revisions\/1542"}],"up":[{"embeddable":true,"href":"https:\/\/www.lenoxesthetics.com\/index.php?rest_route=\/wp\/v2\/pages\/1071"}],"wp:attachment":[{"href":"https:\/\/www.lenoxesthetics.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1216"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}