CRYO T-Shock Waiver

Friday, July 15. 2022 11:28 AM

 

The Cryo T- Shock safely and effectively uses thermal shock to naturally destroy fat cells without any damage to the skin. The Cryo T-Shock breaks down fat cells, which your body naturally flushes out through the bloodstream and then the lymphatic system in days to weeks following the treatment Cryo T-Shock also helps reduce the appearance of cellulite, fine lines and wrinkles by stimulating collagen and elastin production while tightening muscles. Cryo T-Shock is also beneficial for facial toning and lifting. Protocols will be discussed and or adjusted during consultation based on recommendations and clients needs.

I understand that results may vary depending on individual factors including but not limited to medical history, prior treatments of area being treated, skin type, patient compliance with pre/post care instructions and individual response to treatment. I

understand that for purposes of fat/cellulite reduction/skin toning, I must maintain good dietary habits, have sufficient intake of water and participate in light physical activity as well as comply with other items outlined during consultation.

Cryo Slimming Regular Price: $350

Cryo Facial Regular Price: $200

Cryo T-Shock should not be applied over inflamed, infected, or swollen areas of the skin.

Cryo T-Shock should not be applied over/near cancerous areas or on clients undergoing active chemotherapy. Cryo T-Shock should not be used on clients who suffer from Kidney Disease. Cryo T-Shock should not be used on clients on dialysis. Cryo T-Shock should not be used on clients who are pregnant or breastfeeding. Cryo T-Shock facial applications should not be used on clients who have had Botox treatments within 14 days or Filler treatments within 30 days. Cryo T-Shock should not be used on clients who suffer from Severe Diabetes where sensation has been lost in the extremities.

I understand that any procedure involves risk. Risks may include redness, swelling, irritation, skin reaction, or increased heart rate. Some may experience delayed onset muscle soreness from treatments on the stomach due to unintentionally engaging the abdominals, which disappear later that same day. Following any T Shock Fat Freezing or Cellulite Reduction treatment the client understands that a vigorous workout for at least thirty minutes is required the same day or atleast within 48 hours after treatment in order to facilitate lymphatic drainage.

I have been honest and forthright about my medical history, and am healthy to use the device. I am not pregnant, nor any other disease or condition that may be negatively impacted by the Cryo-T Shock Treatment. I give permission to take photographs before and after my session. Photos will only be used to measure progress and will only be seen by the therapist in charge of the treatment.

Photograph Release: I give permission for photographs and other audio-visual and graphic materials to be used for marketing. education-promotion purposes. Although the photographs or accompanying material will not contain my name or any other identifying information, I am aware that I will not be identified in the photos. Photos containing the face can opt to have their eyes censored out if requested Acknowledgement: I understand each person has a different response to the Cryo T- Shock treatment (Most of our clients see results between 4-7 sessions for Cryo Slimming. 1-2 treatments with Cryo Facials The risks, benefits, and possible results have been explained to me. I have been provided the opportunity to ask questions and received satisfactory responses. I agree to have my photograph taken to document my results and will not be used for marketing unless agreed upon (see above

Cancels/Reschedule Policy: All services will be paid in full when scheduling the first appointment after results are seen (Minimum of $150 will be charged per treatment I have been made fully aware that any changes to my appointment need to be made 24 HOURS IN ADVANCE I agree that if am late or need to cancel my appointment, that I will be charged a $25 CHANGE FEE. Should I be late to the point that there is not enough time to perform the service; the appointment will need to be rescheduled on a later date.

BY SIGNING BELOW, IACKNOWLEDGE AND CERTIFY THAT THAVE READ AND UNDERSTAND THE "CONSENT, RELEASE AND INDEMNITY AGREEMENT" FOR THIS TREATMENT, AND THAT I AM SIGNING IT VOLUNTARILY. SHOULD ANY

PAIN OR DISCOMFORT OCCUR I WILL IMMEDIATELY NOTIFY THE GOCRYO STAFF. LUNDERSTAND THAT IMUST BE ATLEAST 18 YRS OLD TO PARTICIPATE IN THIS TREATMENT. LUNDERSTAND THAT ALL SALES ARE FINAL AND REFUNDS ARE NOT PERMITTED.