I have been informed about the treatment, procedure, indications, expected results and possible side effects.
I understand that I am required to have photographs taken before, during and after treatment for my medical records.
Although the results are usually dramatic I have been informed that the treatment is not an exact science and that no guarantees can be or have been made concerning the expected results in my case.
I am undergoing treatment of my own free will. I agree that this procedure is being performed for cosmetic reasons.
I am also aware of and accept the risk of unforeseen complications that may not have been discussed and which may result from this treatment.
I acknowledge my obligation to follow the instructions closely and visit the office as directed.
I certify that I have read the above consent agreement and fully understand it. I also agree to hold harmless and release from any liabilityor any of its officers, directors and/or employees for any condition or result, known or unknown that may arise as a result of any treatment that I receive.