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Microneedling, or collagen induction therapy, is a cosmetic procedure that can help to improve skin appearance. I am pleased to offer it on a trial basis for new patients.

In order to receive microneedling treatment from me, please fill in all of the forms below.

It may take up to 15 minutes. Forms must be submitted ahead of time before your treatment.

Please enter your full name across all forms in order for them to be processed properly.

  1. Medical history
  2. Consultation
  3. Consent, page 1 of 2
  4. Consent, page 2 of 2
  5. Final permission

All of the information you provide is used to inform your treatment and for health & safety purposes. Personally-identifiable information is not shared with any third parties and is only used to inform and improve your treatment.



Information correct as of 12th February 2024.