Acknowledgement and Waiver

 Description of EpiPin

The EpiPin uses 3Dlized, dissolvable Hyaluronic pins that create microchannels (pathways) into the skin which allows a quick. direct penetration of any skincare product used in combination with the EpiPin Pro device. Additionally. the skincare ingredients that form the pin dissolve into the skin filling in wrinkles and creating a smoother complexion.

 

Side Effects

There are no side effects other than a rarely occurring allergic reaction to a skincare ingredient.

Contraindications

There are no contraindications except the skin shows any form of an infection, such as acne pustules or herpes.

 

Patient Consent

I understand that results will vary among individuals. I understand that although I may seea change after my first treatment, I may require a series of sessions to obtain my desired outcome.

 

I am advised that though good results are expected. the possibility and nature of complications cannot be accurately anticipated and that, therefore. there can be no guarantees expressed or implied either as to the success or other result of the treatment. I am aware that the EpiPin facial is not permanent as natural degradation will occur over time.

 

I state that I have read (or it has been read to me) and I understand this consent and I understand the information contained in it.

 

I have had the opportunity to ask any questions about the EpiPin facial including risks or alternatives and acknowledge that all my questions have been answered in a satisfactory manner.

 

This consent form is valid until all or part is revoked by me in writing.