pHformula Stretch Mark Clinical Collaboration 2026
— Consent to Participate & Case Submission
This form should be completed together by the treating Skin Specialist and the participating client. It collects the client's consent to participate, the clinical consultation and history, and the official baseline before photographs. Please do not commence treatment until your case has been reviewed and approved by the pHformula Education Team and your individual treatment protocol has been issued.
Clinic & Skin Specialist Details
Treating Skin Specialist
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Area of the body being treated
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This programme involves a 4-treatment series spaced approximately 4 weeks apart. The protocol is determined by the pHformula Education Team. Results vary, and no specific outcome is guaranteed.
By checking the box below, you confirm you have read, understood, and voluntarily agree to participate.
I have read and understood the above and voluntarily agree to participate
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To ensure safety, the treatment area must not have received prior professional stretch mark treatments, including microneedling, peels, laser, IPL, radiofrequency, ultrasound, plasma, or injectables.
Please confirm that you have not had such treatments on the target area.
Confirmation of no previous treatment
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Details of any previous treatment
I agree to attend all 4 appointments, ensure no other professional treatments are performed on the area during the programme, strictly follow the provided homecare routine, promptly report any reactions or health changes, and attend all scheduled photography appointments.
I agree to the commitments listed above
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Current and previous medical conditions
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Current medications and supplements
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Allergies and sensitivities
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Previous reactions to skincare or treatments
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Age and history of the stretch marks
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Known cause or contributing factors
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Location and extent of the stretch marks
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Current products used on the area
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Recent sun exposure or tanning
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Currently pregnant or breastfeeding?
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I confirm this information is accurate and complete
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Expected temporary reactions include: redness, warmth, tightness, dryness, flaking, swelling, tenderness, and temporary colour changes.
I acknowledge that results vary and are not guaranteed.
I acknowledge treatment expectations
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I agree to use the pHformula SOS Repair Cream as directed by my skin specialist to support healing.
I agree to use the SOS Repair Cream
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Standardised photography will be used throughout the programme: consistent lighting, background, position, camera, distance, framing, and clothing. No filters or retouching will be applied to the images.
I agree to clinical photography standards
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pHformula UK & Ireland may use treatment-area photos for education, case studies, presentations, websites, social media, marketing, and PR.
Please provide your consent below.
I consent to image use for marketing and education
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Participant initials to confirm image-use consent
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Baseline Before Photographs
Please upload your baseline photographs here. Multiple files allowed.
By digitally signing below, I confirm that: I have read and understood this Participant Consent & Agreement; I have had the opportunity to ask questions before agreeing to participate; the information I have provided about my health, medications, skin and previous treatments is accurate to the best of my knowledge; I understand the nature and purpose of the pHformula Stretch Mark Clinical Collaboration and that I am participating in a four-treatment programme at approximately four-week intervals; I understand that no treatment result can be guaranteed; I agree to follow the treatment and post-treatment instructions provided; I will not undergo other professional treatments to the study area during the programme without prior approval; I will immediately report any unexpected or concerning reaction to my treating Skin Specialist; and I have separately read and agreed to the clinical photography and image-use provisions above.
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Skin Specialist Declaration
I confirm that I have reviewed the patient's medical history, fully explained the treatment risks, and will adhere to the supplied pHformula protocol.
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