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Click ‘Get Form’ to open the VI Peel™ Consent Form in the editor.
Begin by reviewing the contraindications section carefully. Ensure you meet the criteria for receiving the treatment.
In the initial section, read each statement regarding your communication with the Physician/Clinician and initial next to each one to confirm your understanding.
Proceed to acknowledge any potential discomfort during and after the procedure by initialing that you understand these risks.
Next, confirm your understanding of maintenance treatments and sun protection requirements by initialing those statements as well.
Finally, sign and date the form at the bottom, ensuring both patient and clinician signatures are included for validation.

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How can I send my vi peel consent form for eSignature?

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What are the dos and don ts of vi peel?

As a general rule, treat it like a sunburn: avoid sun exposure, avoid sweating and avoid heat. During the peeling phase you must avoid sun exposure. Even after the peeling has subsided your new skin will be sensitive to UV light. Protect your investment and reapply your sunscreen when outdoors.

What are the rules for VI peel?

Do not wash, touch, or apply make-up and/or sunscreen for at least 4 - 6 hours while peel is on the skin. APPLY NOTHING. If you have excessive itching or irritation prior to this time period, you may wash the treated area with a mild cleanser and water. DO NOT rub with anything harsh such as a sponge or a washcloth.

How long after vi peel can I shower?

○ Immediately following the peel, skin may look light yellow, red, or tan. This is due to the Retinoic Acid included in the formulation. It is temporary until washed. ○ Please wash your skin after 4 hours (DO NOT USE HOT WATER).

How long can you leave a chemical peel on?

The chemical agent is then applied and typically remains on the skin for 3 to 5 minutes. Most patients feel a mild stinging which is temporary and usually subsides after a few minutes. Some peels are designed to self neutralize and may remain on your skin for 2-4 hours.

How long should you leave VI peel on?

All VI Peel treatments should be kept on for at least 4 hours unless irritation occurs. If irritation occurs, you should remove the peel right away and consult with our team. Do not apply anything on top of the skin for at least 4 hours, including sunscreen.

How soon can I shower after a VI peel?

○ Please wash your skin after 4 hours (DO NOT USE HOT WATER). You may apply a thin layer or post peel protectant (moisturizer included) as needed. If post peel protectant burns you can substitute a thin layer of aquaphor. Apply the SPF if it is daylight.

Can I wash my face 6 hours after chemical peel?

It is recommended to wait until the evening to wash your face, however if you should choose to wash it sooner, please wait at least 2 hours. It is important that you avoid direct sunlight for at least 1 week, and make using a sunscreen with at least SPF40 a long term part of your daily routine.

How long after vi peel can I shower?

○ Immediately following the peel, skin may look light yellow, red, or tan. This is due to the Retinoic Acid included in the formulation. It is temporary until washed. ○ Please wash your skin after 4 hours (DO NOT USE HOT WATER).

Vi peel consent form 2026

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