Skip to product information
CALMING BIO-LIPID REPAIR CREME
  • CALMING BIO-LIPID REPAIR CREME
  • CALMING BIO-LIPID REPAIR CREME
CALMING BIO-LIPID REPAIR CREME
$60.00

Latisse Patient Consent Form

Thank you! Your medical questionnairehas been submitted successfully.
Please fill out all required fields.

1. Ocular History (Eyes)

Are you currently using any prescription eye drops for Glaucoma or ocular hypertension? (e.g., Lumigan, Xalatan, Timolol)
Have you ever been diagnosed with high eye pressure (Ocular Hypertension) or Glaucoma?
Have you had any eye surgery in the last 6 months (Cataract, LASIK, etc.)?
Do you have a history of eye inflammation (Uveitis or Iritis)?
Do you have any active eye infections or chronic "dry eye" symptoms?
Do you wear contact lenses? (Note: Lenses must be removed before application)

2. Medical History

Do you have any known allergies to Bimatoprost or other prostaglandins?
Are you currently pregnant, planning to become pregnant, or breastfeeding?
Do you have a history of skin sensitivity or eczema on your eyelids?

3. Informed Consent & Risks

Please initial next to each point to acknowledge you understand the potential side effects:

Permanent Pigmentation: I understand that Latisse may cause increased brown pigmentation of the colored part of the eye (the iris), which is likely permanent.
Skin Darkening: I understand that darkening of the eyelid skin may occur but is typically reversible if the product is discontinued.
Hair Growth: I understand that hair growth can occur in any skin area that Latisse frequently touches; I will blot any excess solution.
Common Irritation: I understand that eye redness, itchiness, and dryness are common side effects.

Patient Attestation

I certify that the information provided above is true and accurate to the best of my knowledge. I have been informed of the potential side effects and the proper application technique.

Details
Extra-strength, luxuriously rich creme is formulated for extremely dry, sensitive skin; it revives comfort instantly as Merospheres, liposome-encapsulated Rosemary, help direct the repair of skin’s protective barrier down deep, where damage begins. \n

Actions

    • Skin feels ultra-soft, calm, and comfortable within minutes.

    • Skin stays soft, moist, and comfortable for hours.

    • Protects from redness and other signs of irritation

    • Skin acts less sensitive overtime

Skin Conditions

Extremely Dry | Post-Microdermabrasion | Sensitive | Laser or Chemically Treated 

Home Care

After cleansing, apply a moderate amount of creme to sensitive skin. To reduce friction and help prevent redness that can occur during application, warm a dime-size amount of creme between your fingertips and lightly pat and press into the skin. Allow absorbing before applying makeup. It may be worn AM/PM for ‘round the clock deep moisturizing and age-fighting care for sensitive skin, or worn as the night creme when lighter weight Calming Bio-Lipid Repair Fluid is worn throughout the day. \n

 Ingredients

Merospheres (Liposome Encapsulated Rosemarinus Officinalis) | inspires up to 450% increase in barrier lipid production Moisturizing Lipids | hold comforting moisture between cells for hours Lipid-Rich Oils | provide essential lipids for smoother skin; help reduce sensitivity overtime Algae & Mugwort | unique anti-sting complex helps reduce discomfort in sensitive skin Beta Glucans | Biological Response Modifier, challenges skin to correct itself EGCG (Epigallocatechin Galltyl Glucoside) | one of green tea’s most active molecules, it has powerful antioxidant capacities and soothing properties; captures free radicals, detoxifies, and helps prevent the aging effects of stress and pollution.
Materials + Care

We prioritize quality in selecting the materials for our items, choosing premium fabrics and finishings that ensure durability, comfort, and timeless appeal.
Shipping + Returns

We strive to process and ship all orders in a timely manner, working diligently to ensure that your items are on their way to you as soon as possible.

You might also like...