Obagi Tretinoin & Refissa Consent
Review: Obagi-C Rx Skin Health System
Consent*Tretinoin must be used in the prescribed fashion according to the written instructions and descriptions given to me. I understand that I will experience varying degrees of the following symptoms: Dryness – Redness – Exfoliation/Peeling – Itching – Sensitive Skin – Burning – Wrinkles May Look Worse – Acne May Look Worse. These symptoms will lessen and eventually subside as my skin builds tolerance.
Consent*I agree to continue with the use of Tretinoin and to return for follow-ups as directed. Doing so will help with my safety and provide adjustments towards maximizing results.
Consent*I understand the best results are achieved with adherence to the program over several weeks and/or months.
Consent*I understand that excessive application of the products or picking, rubbing the skin can cause a great deal of discomfort and even blistering, especially in the early weeks of treatment. If any reactions are initiated to the point of skin breakdown or infection, I will contact the office immediately. Careless inattention to such reactions may result in complications such as infection, injury, discoloration, or possible superficial scarring.
Consent*I understand that it is necessary to maintain the use of my prescribed protocol throughout the treatment period. This is necessary to retain the benefits during the program.
Consent*I understand a sunscreen of at least SPF 50 is to be used on a daily basis, and to practice sun safe guidelines when outdoors.
Signature*
For New And Returning Patients:
This is a prescription product. You must complete all Good Faith Exam forms in order for us to complete this order. If you already have completed all prescription form, check the consent box below and add the item to your shopping cart.
Please list your current medications, or state “none”*
Tell us about any allergies that you have, or state “none”*
Have you started any new medications since the last time you filled out this form?*
Do you visit a tanning salon?*
Do you follow a restricted diet?*
Do you wear contact lenses?*
Do you have metal implants, a pacemaker or body piercings?*
Do you drink more than 4 caffeinated beverages daily (coffee, tea, soft drinks?*
Rate your level of stress on a scale of 1 to 5 *Please enter a number from 1 to 5.
Great Line Of Products
I tried the Obagi-C Fx System set – Normal to Oily Skin for my combination, acne prone skin. With regular use, it helped improve the overall appearance of my skin, with no irritation. Small dark spots disappeared fine line and wrinkles were minimized my complexion got smoother and brighter it also controlled the excess oil and shine on my forehead and chin.
LovelySkin Customer
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The Best Skin Care Ever
I used this product many years ago, back in the 90s and have wanted to use it again. I’m thrilled to see we can purchase ok online rather than getting it through a physician. I used to order through my surgeon. The retinal A is a must in my opinion. It’s like a mild skin peel allowing fresh, soft skin through. It’s AMAZING!
Alex369
Skin Deep Skin Tone Enhancement System Consent
Consent*The pads must be used in the prescribed fashion according to the written instructions and descriptions given to me. I understand that I may experience varying degrees of the following symptoms: Dryness – Redness – Exfoliation/Peeling – Itching – Sensitive Skin – Burning – Wrinkles May Look Worse – Acne May Look Worse. These symptoms will lessen and eventually subside as my skin builds tolerance.
Consent*I agree to continue with the use of the Skin Deep Skin Tone Enhancement System as directed. Doing so will help with my safety and provide adjustments towards maximizing results.
Consent*I understand the best results are achieved with adherence to the program over several weeks and/or months.
Consent*I understand that excessive application of the products or picking, rubbing the skin can cause a great deal of discomfort and even blistering, especially in the early weeks of treatment. If any reactions are initiated to the point of skin breakdown or infection, I will contact the office immediately. Careless inattention to such reactions may result in complications such as infection, injury, discoloration, or possible superficial scarring.
Consent*I understand that it is necessary to maintain the use of my prescribed Skin Deep Skin Tone Enhancement System protocol throughout the treatment period and also during the maintenance period. This is necessary to retain the benefits during the program.
Consent*I understand that I must adhere to the guidelines prescribed.
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How Supplied
Obagi-C® Rx System C-Clarifying Serum for Normal to Dry Skin is available as follows: 1 fl. oz. bottle NDC 62032-106-10
Obagi-C® Rx System C-Clarifying Serum for Normal to Oily Skin is available as follows: 1 fl. oz. bottle NDC 62032-122-10
Obagi-C® Rx System C-Therapy Night Cream is available as follows: Net wt. 2 oz. bottle NDC 62032-105-36
Store at controlled room temperature: 15° to 25°C . Keep out of direct sunlight.
Distributed by Obagi Cosmeceuticals LLC, Long Beach, CA 90806
