Consent for Scalp Mesotherapy Treatment with Vital Injector 2

Consent for Service / Scalp Treatment

To be completed by the client

Have you undergone any scalp treatments in the past six months?
Have you undergone any medical procedures or surgeries in the past six months?

To be completed by the salon

Maximum file size: 268.44MB

Consents and Declarations

To be completed by the client
Consent for Scalp Mesotherapy Treatment with Vital Injector 2
Device Information:

Vital Injector 2 is a modern medical device used for the precise and safe delivery of nutrients, vitamins, and moisturizing cocktails deep into the scalp. The microneedling mesotherapy treatment performed with this device effectively improves hair condition, strengthens hair follicles, and helps prevent hair loss.

Vital Injector 2 is medically certified, ensuring it meets the highest standards of safety and effectiveness.

I have been informed about the following contraindications for the procedure. I declare that:
Statement and Consent for Treatment​

Data Processing

GDPR Consent
Consent for Electronic Communication
Consent for Electronic Communication

Post-Treatment Recommendations

I have been informed of the necessity to follow the following post-treatment recommendations, non-compliance with which may cause serious complications:

• Avoid sun exposure until the scalp is fully healed.
• Avoid bathing in chlorinated water and refrain from using the sauna for at least 3 days, or longer in case of severe irritation until the scalp is healed.
• Avoid treatments that may irritate the scalp, including all types of peels, for at least 7 days, or longer in severe cases until the skin is healed.
• Refrain from gym workouts, fitness activities, and physical exertion for at least 24 hours after the procedure.
• Protect the scalp from sun exposure after the treatment.
• Do not use hair styling products for 24 hours after the procedure.
• Avoid alcohol consumption for at least 24 hours after the procedure.

Risks and Possible Complications of the Procedure

I have been informed about the possible risks and complications associated with the procedure, including:

• Redness, swelling, or irritation of the scalp
• Allergic reactions to substances applied during the procedure
• Hematomas or bruising at the injection sites
• Scalp infection due to microtraumas
• Pain or discomfort at the treatment site
• Itching of the scalp due to post-treatment irritation

GDPR Information Clause

GDPR Information Clause

In accordance with Article 13 of the GDPR, DW GROUP Sp. z o.o., based in Pruszków, informs that:

a) The data controller of the Client’s personal data is DW GROUP Sp. z o.o., with its registered office in Pruszków (05-800) at Raszyńska 11, KRS: 0000948917, NIP: 5342647256, tel. +48 883 568 858, email: info@dwcreative.group.pl(hereinafter: Administrator).

b) The personal data provided by the Client (Personal Data) will be processed with full respect for individual rights and freedoms, based on Article 6(1)(a-c) and (f) of the GDPR, based on the consent given by the Client and for the legitimate purposes of the Administrator, including:

i. Registering the Client for a hairdressing service and sending reminders about the appointment,

ii. Performing the hairdressing service,

iii. Marketing and promotional activities of the Administrator,

iv. Processing and handling submitted complaints,

v. Publishing materials containing the Client’s image,

vi. Processing materials containing the Client’s image,

vii. Enforcing claims through legal proceedings,

viii. Ensuring the security of employees, collaborators, clients, and property in the salon – video surveillance.

c) Providing Personal Data is voluntary but necessary for the proper execution of the hairdressing service. Refusal to provide personal data will prevent the Client from scheduling and receiving the service.

d) Personal Data will be processed by the Administrator for five (5) years due to tax and accounting obligations.

e) The Administrator will not transfer Personal Data to other entities unless required by law or justified by the Administrator’s legitimate interest (e.g., to accounting service providers).

f) The Personal Data entrusted to the Administrator will not be subject to automated processing or profiling.

g) Every Client has the right to access their Personal Data and to request its rectification, correction, restriction of processing, transfer, or objection to processing. Such requests should be sent to the Administrator’s contact details specified in point (a). The Administrator will process the request within 30 days from the date of receipt.

h) The Client has the right to withdraw consent for the processing of Personal Data at any time, without affecting the lawfulness of processing carried out before the withdrawal of consent.

i) The Client has the right to lodge a complaint with the supervisory authority, i.e., the President of the Personal Data Protection Office.

j) The Client’s Personal Data will not be transferred outside the European Union or to international organizations. However, the Administrator informs that materials containing the Client’s image, as mentioned in § 11 of the Regulations, may be published on social media platforms such as Instagram and Facebook.

k) The Administrator’s contact details are provided in point (a) above.

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Koloryzacja jednolita

Koloryzacja jednolita przeznaczona jest dla osób, które chcą mieć na całych włosach kolor w jednym odcieniu, zazwyczaj zbliżonym do naturalnego. Pozwala ukryć tzw. odrost oraz siwe włosy, a także pogłębić odcień na długościach.

Trzeba jednak pamiętać, że w przypadku znacznych zmian koloru włosów może być konieczny zabieg wcześniejszej dekoloryzacji lub repigmentacji (gdy zmieniamy kolor na ciemniejszy).

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