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HYDRATING VITAMIN CREME
  • HYDRATING VITAMIN CREME
HYDRATING VITAMIN CREME
$69.00

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
Rich in vitamins and water-soluble blends of silicon complexes, this lightweight yet lubricious creme gives skin a moist glow that lasts throughout the day. \n

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    • Soft, moist, healthy-looking skin

    • Instantly smoothes dehydration lines

    • Helps fight free radicals for stronger, more resilient skin over time

    • Improves moisture retention for a healthy, long-lasting glow

Skin Conditions

Normal | Slightly to Extremely Dry | Combination | Mature/Maturing | Blemished/Blocked Pores | Slightly Oily | Dehydrated. 

Home Care

Smooth over clean skin, morning and/or night. 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. 

Ingredients

Sodium Hyaluronate Dimethylsilanol | bioactive moisturizer binds 1000 times its weight in water Tocopheryl Linoleate | moisturizing Vitamin E, forms comforting pillows of moisture for 16-20 hours Tocopheryl Acetate | Vitamin E ester keeps s kin lipids fresh, protects natural radiance Shea Butter | emollient “butter” from the Karite Nut Tree; softens skin and promotes surface repair Retinyl Palmitate | a storage form of Vitamin A visibly improves surface signs of aging Chlorella Vulgaris | peptide-rich microalgae protects and revives skin’s strengthening proteins to produce deep-down line-smoothing over time. Tetrahexyldecyl Ascorbate (Vitamin C) | lipid-soluble, bioavailable, and stabilized Vitamin C Sea Water | rich in purifying minerals and trace elements, hydrates, soothes and supports skin’s self-repair.
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.

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