PRP & Vampire Facial Consent Form (Free Template)

PRP serum tubes on a clinical tray with a centrifuge

PRP microneedling (the “vampire facial”) uses your client’s own blood, so the consent needs to cover the blood draw and infection control on top of the microneedling itself — the exact issues behind the well-publicized unlicensed-spa cases. Below is a free PRP facial consent form template, plus the complete kit.

Important: This template is for professional convenience and information only and does not constitute legal advice. Drawing and handling blood is regulated and often restricted to specific licensed providers, with strict infection-control requirements that vary by state and country. You are responsible for your scope of practice and compliance where you work. Review these forms with your own qualified legal counsel and insurer before use.

What a PRP / vampire facial consent form must include

  • The blood draw and that it is performed by a qualified, licensed person
  • Infection control: single-use, sterile, never-shared equipment
  • Blood-draw risks (bruising, fainting, site infection) plus microneedling risks
  • Contraindications (blood disorders, blood thinners, active infection, chemotherapy)
  • No-guarantee, elective, non-refundable statements
  • Signature, date, and photo/records consent

Free PRP / vampire facial consent form template

Copy, print, or adapt the template below. For the editable version plus the other five forms, see the full kit.

Informed Consent: PRP Microneedling / Vampire Facial

Client name: __________   DOB: ________   Date: ________

About the procedure. A small sample of your own blood is drawn and spun in a centrifuge to concentrate platelets. The platelet-rich plasma (PRP) is applied during or after microneedling (and/or injected, where within the provider’s scope). The blood draw is performed by a qualified, appropriately licensed person.

Blood safety. Only your own blood is used, and single-use, sterile needles and equipment are used and never shared between clients. Sterile technique is essential to prevent infection and blood-borne transmission.

Risks. From the blood draw: bruising, bleeding, discomfort, lightheadedness/fainting, rarely infection at the site. From microneedling/PRP: redness, swelling, bruising, and less commonly infection, pigmentation change, or scarring. Results vary and none is guaranteed.

Contraindications (may decline if any apply): pregnancy/nursing, blood or platelet disorder, low platelets/anemia, blood thinners, active or blood-borne infection, active cancer/chemotherapy, immunosuppression, keloid history, isotretinoin within 6 months.

Consent. The blood draw, procedure, risks, and alternatives have been explained; no guarantee is expressed or implied; this is elective and non-refundable. I have read and understand this form and consent to the blood draw and treatment. Valid until revoked in writing.

Client signature: __________ Date: ______    Provider/Witness: __________ Date: ______

Get the complete PRP & Vampire Facial Documentation Kit

The free consent above is one of six. The full editable kit covers your whole workflow:

  • Informed Consent
  • Client Intake & Health History
  • Pre-Treatment Care
  • Aftercare sheet + card
  • Treatment Record
  • Photo Consent & Release

Editable, plus fillable PDF and Word. Launching soon. Email outreach@proneedling.com for early access.

Get early access

Frequently asked questions

Do you need a consent form for a vampire facial?

Yes. A vampire facial involves both a blood draw and microneedling, so informed consent should cover the blood draw, infection-control measures, the risks of each step, and a no-guarantee statement.

What are the risks of PRP microneedling?

Blood-draw risks (bruising, bleeding, fainting, rarely infection at the site) plus microneedling risks (redness, swelling, bruising, and rarely infection, pigmentation change, or scarring). Proper sterile, single-use technique is essential.

Can I edit this form?

Yes, copy and adapt the free template. The full kit is editable plus fillable PDF and Word.