Terms & Conditions

Read this document carefully and if you agree that you have read the information leaflet, sign below.

Everything about the above-named procedure is your satisfaction. I have checked that the information on this questionnaire and registration form are correct and only those marked were discussed, approved and verified.

I authorize and consent to treatment by improving the appearance of certain skin/face/skin-tightening using the equipment labeled on page.

I have been advised of the advantages and disadvantages associated with the above procedure and suggested treatment plan. The therapist has adequately explained the proposed procedure and alternatives.

I understand that treatment experience and results will vary between persons. The result is not guaranteed and as with all treatments, there are inherent risks, outcomes can be variable, and no promises have been made to me as to expected outcomes.

I understand that the primary benefits are for personal image and not for any medical or essential health reasons.

I am satisfied that I have had enough “cooling-off” opportunity to enable me to make a rational decision.

I accept that the cosmetic improvements are secondary to a healthy lifestyle and sensible diet and that exercise regimes must be maintained.

I have been given enough opportunities to ask questions and seek further information and have received satisfactory answers to all of them.

I accept, although rare, that adverse outcomes such as pain, swelling, bruising, infection, numbness, scarring and lumps may occur.

I am aware that with the relatively new procedures, there are no long-term studies on adverse effects and complications.

I authorize the taking of photographs.

I understand that the use of such equipment is optional and entirely at my own risk.

I have completed a medical questionnaire and can confirm that all information is correct.

Client Signature: _______________________

Therapist Signature: ____________________

Date: ____________________