Evolution Electrolysis Registration

Congrats!

You took your first step towards becoming permanently hair free!

Complete this form and you will get:

A free electrolysis consultation and skin check at our clinic in Camp Hill, Brisbane
No-cost follow up consultations for any concerns
An information pack containing need-to-knows about electrolysis and laser hair treatment
A no-pressure invitation to secure guaranteed electrolysis sessions - until you are hair free!

Sound good? Hit next below to register your details.

If you are affected by any of the below circumstances, we cannot treat you until the circumstance resolves completely (if at all possible).

Religious/personal issues having treatment undertaken by a member of the LGBTQI+ community
Cochlear implants
Attempting pregnancy, currently pregnant or breastfeeding
Cancer of any form, unless more than 5 years in remission
Blood thinning medication
Keloid scarring (scarring that raises above the surface of the skin)
Immunotherapy
Dermographia
Heart pacemaker or other heart regulatory devices
Any electrically stimulating implant device
Haemophilia

Click here if you are unaffected by the above conditions.

You must click the box to continue registration.

Contact Details

Please supply your details so we can contact you.

Preferred first name

Please provide your first name.

Mobile phone number (no spaces, e.g 0412345678)

Please check your mobile number is entered and no spaces are used.

Email address

Please check your email address was entered correctly.

Prior Treatment

Have you had laser hair reduction or electrolysis previously?

I've never done laser hair reduction or electrolysis before I've only had laser hair reduction before I've only had electrolysis before I've had both laser hair reduction and electrolysis before

You must choose an option to continue.

Clearance Areas

Where do you want to be hair-free?

Weekly Availability

What's your availability for treatment look like?

Time	Mon	Tue	Wed	Thu	Fri	Sat	Sun
11am – 1pm
2pm – 4pm
5pm – 7pm
Not available

You must ensure there is at least one valid entry for every day.

Surgery Planning

Do you need hair clearance for surgical reasons?
If so, when is the surgery planned?

NO - No surgery planned or intended YES - Surgery within next 2 years YES - Surgery planned 2+ years in the future

You must select one option to continue.

Affordability

Electrolysis requires a financial commitment. Normal treatment rates are $220 for a 2 hour session. Based on your availability, lifestyle and budget, how often could you attend treatment after your free consultation?

Daily (including bulk/all-day sessions) Weekly Fortnightly Monthly Longer than 2 months between sessions I could not afford electrolysis after the consultation