Microcurrent facial consent form: the hard stops, the odd sensations and the series
On most of my facial consent forms, a yes on the checklist means I adjust. Microcurrent is different. Some answers are a flat no, and the form should say so in black and white before the client ever lies down.
This exact form is built into SlickChart, so you can send it to your client's phone to sign before the visit.
Put the hard stops at the top of the checklist
My screening section doesn't bury the important part. It opens with this:
An implanted electrical device, epilepsy, pregnancy or active cancer means no microcurrent. For other yes answers I follow the device maker's guidance and may ask for your physician's or injector's OK.
Nobody feels singled out when the policy was printed before they checked anything. Then the full list:
- Pacemaker, defibrillator or other implanted electrical device
- Epilepsy or a history of seizures
- Pregnant or possibly pregnant
- Active cancer, or a suspicious spot in the area
- Heart condition, or blood clots or thrombosis
- Metal plates, pins or threads in the face
- Botox or filler recently
- Facial surgery or laser recently
- Bell's palsy, or numb areas on the face
- Broken skin, rash or infection in the area
"Possibly pregnant" gives an unsure client a way to say so. The checklist is a screening tool, never a way to name a condition: when in doubt, ask for the physician's OK.
The injector question
Injectables get their own attention. "Botox or filler recently" sits on the checklist, the form mentions an injector's OK by name, and my health agreement spells it out:
"I've shared my health history honestly and will tell you about any change, new implant or injectable before each session."
The aftercare backs it up, asking clients not to book injectables before asking me.
Describe the treatment, including the weird parts
My "about" section explains that microcurrent is a very low-level electrical current, delivered through probes or tips over a conductive gel, used to temporarily tone and lift the look of facial muscles and skin.
Then the part clients really need: what they'll feel. Mostly nothing, or a light tingle. But some people notice a metallic taste or brief flashes of light near the eyes. If you don't warn about those, a client experiencing them for the first time will assume something has gone wrong. The form tells them to say so, and that you'll lower the setting.
"What to expect" covers no downtime, effects that are temporary and build with a series of 6 to 12 sessions, then regular maintenance. Alternatives include no treatment, facial massage, homecare products, or a referral to a physician for injectables or other medical treatments.
Risks: uncommon, but listed
My risk section is labeled uncommon and covers brief redness, tingling or mild muscle twitching; headache or tiredness after treatment; skin irritation from the conductive gel; and a temporary metallic taste or light flashes. A client who feels tired that evening then knows it was expected.
Practical agreements
Two lines are specific to this service. The client agrees to remove jewelry from the area and to speak up if they feel discomfort, and that they can stop at any time. And because microcurrent is usually booked as a package, the client confirms the form covers the series, their questions were answered, and services can't be refunded. A guardian name for anyone under 18 and a signature close it out.
Aftercare that keeps the series on track
The guide opens by setting the frame: the lifted, toned look is temporary and builds with regular sessions. Then by stage:
- Right after: a lifted, refreshed look, light pinkness or a faint tingle. Makeup is fine. Drink plenty of water, and avoid heavy rubbing or massage tools on the face for the rest of the day.
- First 24 hours: some people feel mildly tired or have a light headache. Stay hydrated, rest if needed, and skip strong exfoliants or new actives.
- Between sessions: the effect softens over a few days, and each session tends to hold a little longer. Avoid long gaps early in the series.
- After the series: maintenance about every 2 to 4 weeks, and no home microcurrent device without asking first.
It ends with when to call: a rash or itching lasting more than a day, a headache that lasts or keeps coming back, twitching, numbness or weakness in the face, or any change near a filler or injectable area. For keeping a series booked, see rebooking for solo estheticians.
Questions to decide for your own practice
- What does your device maker list as contraindications, and does your form match?
- Will you require written physician or injector clearance, or a verbal OK noted in the chart?
- How long after Botox or filler will you wait? Write your answer down.
- How will you handle a series that a hard stop interrupts partway through?
Consent requirements and scope of practice vary by state, so check with your state board. This is not legal or medical advice.
Using it digitally
SlickChart has this exact form and aftercare built in for esthetician subscribers. The client signs on their phone before the visit, or on your device in the room, and any checked contraindication is flagged for you, which matters most when a box is a hard stop. The aftercare goes to the client's own app, styled with your logo, and it works alongside the Square account you already have. If that would take paperwork off your plate, try SlickChart.
Prefer paper? The printable microcurrent facial set, with the consent form, protocol and aftercare, is in my Etsy shop, ready to print or edit in free Canva.