REASONING: 

I have been advised that PRP is used to stimulate the body to repair and regenerate weak and damaged connective tissue which are believed to cause pain and instability. It is also used to decrease pain and improved function in some forms of arthritis.  The procedure requires the injection of PRP derived from a small sample of my own blood, according to standard preparation techniques.  The injection is localized to the area of concern.

I have been informed that the procedure has been used on many patients and has been proven safe. The procedure may initially increase my painful area or reproduce my symptoms for one to three days (and occasionally as long as ten days) and then may decrease my pain complaints, but may not completely eradicate them. I understand that although the use of PRP is supported by known scientific principles and understanding of platelet physiology, PRP treatments are still considered to be experimental due to the lack of large research studies in the scientific literature.

ALTERNATIVE TREATMENTS:

Alternative treatments have been reviewed with me including: doing nothing, other injections such as steroids, hyaluronic acid or local anesthetics, physical therapy, braces, energy devices including ultrasound and shockwave, acupuncture, and surgical intervention. 

BENEFITS: 

I understand the potential benefits of the procedure are improved or resolved pain and improved function.  I understand and acknowledge that results cannot be guaranteed, individual response varies, and multiple treatments may be recommended for best results. 

RISKS AND COMPLICATIONS OF PRP INJECTIONS: 

Overall, PRP is considered very safe and the risk of allergic reaction is very low, as PRP is derived from a sample of the patient’s own blood.   However all procedures carry risk.  The risks of this procedure have been explained to me, including swelling, stiffness, decreased range of motion, bleeding, bruising, infection, and damage to nearby tissues, vessels, nerves.  Other risks for this procedure may include: headache, no decrease in pain, or an increase in pain. 

OTHER POSSIBLE RISKS OF PRP INJECTIONS AND/OR MICRONEEDLING:

Bleeding, infections, no effect at all, allergic reactions, alteration of facial features, hematoma or bruising, hyperpigmentation, hypopigmentation, need for subsequent surgery, scar formation, local tissue infarction and necrosis, erosions, fatigue, damage to eyes, ears, nose, mouth, procedural pain, post-operative pain, prolonged pain, intractable pain, failed procedure, varied results, psychological alterations, relationship problems, possible hospitalization for treatment of complications, lidocaine toxicity, anesthesia reaction, embolism, depression, reactions to medications including anaphylaxis, nerve damage, permanent numbness, slow healing, swelling, allergy, nodule formation.

CONTRAINDICATIONS:

Absolute contraindications include:  Critical thrombocytopenia; Hemodynamic instability or septicemia; active or chronic infection for example: cellulitis, or adjacent osteomyelitis; chronic liver disease; platelet abnormalities; platelet dysfunction syndrome
 
Relative contraindications include the following:  Regular nonsteroidal anti-inflammatory drug (NSAID) use within 48 hours of the procedure; corticosteroid injections within 1 month or systemic corticosteroid use within 2 weeks; recent fever or illness; cancer, particularly of bone or blood; anemia, with a hemoglobin level lower than 10 g/dL; Thrombocytopenia, with a platelet count lower than 110/μL

PRP / Biologic Injection Therapy – Treatment & Financial Policy

Our clinic provides platelet-rich plasma (PRP) and related biologic therapies as elective regenerative treatments intended to support the body’s natural healing processes. These therapies are offered after careful medical assessment and discussion of potential benefits, limitations, and alternatives.

1. No Guaranteed Outcomes

PRP and other biologic treatments do not produce    results. Clinical response varies based on many factors, including:

•  Severity of underlying joint degeneration or tissue damage
• Age-related healing capacity
• Metabolic and inflammatory conditions
• Mechanical factors (eg. Cartilage degeneration) that cannot be reversed 

While some patients experience meaningful improvement, others may have partial benefit or no improvement.  Some disease states (eg arthritis), may worsen with or without treatment.  Lack of response does not indicate that the treatment was performed incorrectly or caused harm.

2. Not a Curative or Restorative Procedure

These therapies cannot:

• Regrow cartilage 
• Reverse osteoarthritis
• Repair complex degenerative meniscal disease
• Prevent natural progression of structural joint conditions

They are intended to modulate inflammation and support repair where biologically possible. 

3. Expected Post-Injection Symptoms

Temporary discomfort, stiffness, or inflammatory flare may occur following treatment and typically resolves within several days. These effects are part of the biologic response.

4. Fees Reflect Professional Services Rendered

Fees charged for PRP therapy cover:

 

• Medical evaluation and determination of candidacy
• Specialized preparation of the autologous biologic product from your blood
• Procedure time, equipment, and technical expertise
• Post-procedure assessment and guidance

These fees are for services performed, not for a guaranteed clinical outcome.

5. Refund Policy

Because regenerative therapies are not outcome-based products, refunds are not provided due to lack of improvement or symptom persistence. This policy is consistent with other medical treatments where results cannot be guaranteed.

6. Ongoing Care

Our role is consultative and procedure-focused. Long-term management of underlying musculoskeletal disease, pain control, mobility decline, or surgical decision-making remains with the patient’s primary physician and/or appropriate specialists.

7. Commitment to Ethical Practice 

We carefully assess each patient’s suitability before proceeding and may recommend against treatment when the likelihood of benefit is low. Our goal is always to offer therapies responsibly, transparently, and in the patient’s best medical interest.

I understand photographs and/or video or electronic recordings may occur during my procedure and may be used for internal performance improvement or educational purposes. 

I understand that this treatment is voluntary and I agree to pay all costs associated with the procedure myself.  I understand that results are not guaranteed and no refunds will be given. 

Acknowledgement:

By signing below, I acknowledge that I have had the opportunity to ask questions and understand that PRP / biologic therapy is not guaranteed to improve my condition and that fees are for services rendered.