Best dermalogica facial services Singapore | pdpa form - Best Facial Singapore | We listen, advise then we treat

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Acknowledgement *

I understand that if i'm below 18 years old i'll need a accompanying parents or legal guardian at my initial consultation

Are you 18 years old & above? *

Full name of parents or legal guardian *

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Last

Contact details of parents or legal guardian *

By providing your particulars you agreed to the terms and conditions of PDPA *

Yes I agree to the terms & conditions stated above

By providing your particulars you acknowledge that all services packages SOLD are non-refundable and products SOLD are non-refundable & exchangeable in Pure Element *

Yes I agree to the terms & conditions stated above

I'm aware of all side effect which might occur after my treatment *

Yes I agree to the terms & condition stated above

I'm fully aware of all the side effects which might occur during the treatment i'm doing now and I fully understand that all treatment results are not guaranteed, it's up to individual's recovery and different skin/body condition react differently. I'm not supposed to do any self treat after my treatment. Pure Element is not responsible for any touch up, sensitivity or side effects after the treatment. But we'll be there to advise you on what to do and make changes to your treatment if it's necessary. You'll never be alone. We'll always be there for you. Please check and make sure everything is good before you leave *

Yes I agree to the terms & conditions stated above

Name *

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Marital status *

Date of birth *

Phone Number *

Email *

What is your skin/body concern? *

Do you have any current or past medical condition(s)? *

I understand that I should always update Pure Element whenever there are changes in my medical conditions *

Yes I accept the terms & conditions stated above

I acknowledge that I have provided the correct information above *

Yes I accept the terms & conditions stated above

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Our Address:
Pure Element- The Best Dermalogica Facial Singapore
Ang Mo Kio Blk 233 Ave 3 unit no. #01-1180 Singapore 560233