Laser Hair Removal Treatment Sheet
First Name
*
Last Name
*
Email
*
Patient email on file
Laser Treatment Log
Date
Treatment Type
Laser Used
Pulse Duration MS
Fluency j/cm2
HTZ
COOLING
Treatment Number#
1
2
3
4
5
6
7
8
Provider Name
Provider Signature
Date
-
Month
-
Day
Year
Date
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