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Vi Peel Consent Form
Have an aspirin allergy or phenol allergy
Patients who have used within the past 3 months
Patients who on any medications that causes photosensitivity
Patients who have active cold sores, warts, open wounds or history of herpes simplex
Patients who are undergoing chemotherapy and or radiation therapy
Patients with a history of an autoimmune disease or any condition that may weaken their immune system
Please read and initial the following:
_______Prior to receiving...
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