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MOISTURE REPLENISHING CREME
  • MOISTURE REPLENISHING CREME
MOISTURE REPLENISHING 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
European studies prove the balancing ingredient in this buttery – yet greaseless – creme works with skin’s natural moisturizing lipids to normalize oily skin in only 15 days and dry skin within 45 days. 

Actions


    • “Smart” moisturizer adjusts to the hydration needs of any skin

    • Vitamins A, C & E deliver day-to-day visible age-correction

  • AM/PM moisturizer eliminates the need for a night creme

Skin Conditions

Dry | Oily | Combination | Normal. \n

Home Care

After cleansing, apply a moderate amount of creme to normal to slightly dry 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. To help the creme absorb more evenly and thoroughly, remove troublesome dead skin cells one-to-three times a week with a creamy, granular exfoliant or gentle, non-granular gommage. 

 Ingredients

Moisturizing Lipids | found naturally in the skin, these lipids hold comforting moisture between skin cells Panthenol | ProVitamin B5; returns skin’s moisture levels to normal; helps smooth fine lines and other signs of surface aging Lipid-Rich Lubricants | provides essential lipids to smooth rough skin and reinforce skin’s natural barrier Sodium Hyaluronate | bioactive moisturizer; holds up to 1000 times its weight in water on the skin Beta Carotene | ProVitamin A; most active antioxidant form; protects DNA from free radical damage Green Tea | standardized for natural soothing antioxidants
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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