I hereby consent to the Collagen silk thread lifting needle-free treatment of which I understand that more than one (1) treatment will be required.  I understand that the benefits of Collagen silk thread lifting may vary, but may include: a possible decrease of wrinkles, smoother appearance of the skin.

Contraindications:
- active acne, acne or retin A meds should be stopped min 10 days before treatment - autoimmune diseases
- cancer
- pregnancy, breastfeeding
- open wounds
- active herpes
- eczema

24 hours post-treatment:
- do not wash or steam your face
- do not use sauna
- do not use peelings
- do no use retinol products
- starting on second day post-treatment use SPF and hyaluronic serum

The information provided has been explained to me and all my questions have been answered to my satisfaction.  I have read the above information, and I give my consent to have the Collagen silk thread lifting needle-free treatment by the staff at Bella Day Spa.  

By signing below, I acknowledge that I have read the above information and give my consent to be treated with the Collagen silk thread lifting needle-free.  This consent form is valid for all same future treatments.  I will alert the staff if there are any future changes to my medical history.