• Client Booking Form and History

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  • Medical History

  • Typical Daily Foods And Drink Intake

  • I (print your name)_______________________________ consent to allow Newbody Formations staff members to consult with & evaluate me in order to determine if I am agood candidate for the Non-surgical Body Contouring Program. I understand thatphotographs and measurements will be taken and kept in my file.
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  • Treatment Agreement and Consent Form

  • I ____________________________, duly authorize the technicians of Newbody Formations to perform that Laser Lipo and/or the Lipo Light procedure(s) for the purpose of spot fat reduction/ improvement of cellulite, and/or butt & breast enhancement. I am aware that clinical results may vary depending on individual factors including but not limited to medical history, client compliance with pre-care and post-care treatment instructions, and individual bodily response to treatment. I have been made aware that my diet and the amount of exercise I do will have a major effect on the results of my treatments. If I do not make an effort to address my dietary requirements and exercise I am aware that the results achieved may not be retained. I understand that laser body contouring involves a course of treatment and all sales are final. Services and treatment packages are non-refundable and non-transferable. The fee structure has been fully explained and I understand that I am required to pay for a course of treatments prior to any procedures taking place. I am fully aware that should I wish to cancel the course the outstanding treatment value is non-refundable. 
  • The course cost is $_________ for ____________________ treatments. Individuals with any of the following conditions or net candidates for treatment with any of our body contouring lasers. 
  • Contraindications include:
    Pregnancy (within 6 months)
    Epilepsy
    Uncontrolled Thyroid Gland Dysfunction
    Uncontrolled Hypertension
    Cardiac Arrhythmias or Heart Disease
    Pacemakers
    Recent or current history of cancer or actively undergoing radiation or chemotherapy
    Liver/kidney disease
    Photosensitivity to 650 to 660nm of light
    Immuno-suppressed disorders
    Current infection (including viral)
    Currently not on Menstrual Cycle or haven’t been in the last 2 days
    Individuals must reframe from the use of blood thinners, antibiotics (with-in 10days prior
    to treatment), steroids (3 weeks prior)

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  • This is a fill in the field. Please add appropriate fields and text.
  • I understand that with some skin types, there is a risk of temporary redness and/or
    discoloration of the skin localized in the treatment area that can last up to several hours.
    There is also a possibility of tattoo lightening if located in the treatment area.
    I certify that I have been fully informed of the nature and purpose of the procedure,
    expected outcomes, and possible complications. I understand that no guarantee can be
    given as to the final result obtained. I am fully aware that my condition is of a cosmetic
    concern and that the decision to proceed is based solely on my expressed desire to do
    so.
    I understand that it is my personal responsibility to inform the laser technician of the
    clinic named above of any changes to my medical history during the course of laser
    body contouring treatment sessions. I confirm that should this occur, I shall advise the
    technician of any changes.
    I certify that I have been given the opportunity to ask questions, any questions have
    been answered to my satisfaction, and that I have fully read and understood the
    contents of this consent form.

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  • Pre-Care Instructions

  • Before any treatments can be performed you must detox. Detoxing can be done In-office, allowing you to
    receive treatment instantly after performing a foot detox. Or we can provide/ recommend a detox tea
    which must be consumed at home and you may return back after 24 hrs to have any treatment perform.
    ● Avoid eating two hours before and after treatment sessions
    ● Avoid heavy meals on the treatment days.
    ● Drink plenty of water to facilitate lymphatic drainage
    ● Limit carbonated drinks, coffee, and tea during the treatment period.
    ● Avoid fasting or the body will go into “starvation mode” and become more resistant to the release
    of stored fat.
    ● Within the two hours following treatment, the client MUST perform 30-45 minutes of
    cardio-vascular work-out in order to create the energy demand that will facilitate metabolism of
    the fatty acids and glycerol freed from the fat cells.
    ● Must wear shapewear 5 to 8 hours per day during the duration of receiving treatments the more
    you wear the garment the more consort your body will become.
    I certify that I have been counseled in the pre and post-treatment instructions and have been given a copy
    of them. I have read and understand the instructions and realize that I must follow these instructions
    diligently in order to obtain optimum results.

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  • Liability Waiver Spa Fitness Equipment and Heat Sauna Liability Waiver

  • I, __________________________________, acknowledge that I will be engaging in unsupervised activities at Newbody Formations, which may lead to personal injury. I agree to assume all responsibility for any personal injury that may occur. I hereby authorize the staff to act on my behalf, if I am unable to do so, to the best of their ability in an emergency requiring medical attention. I assume personal responsibility for any damages that may result from an injury. I furthermore agree not to hold Newbody Formations responsible for any injury that might occur during my participation in all activities associated with fitness performed in the facility. Please be informed that all Weight Reduction treatments must be completed entirely before any enhancement treatments can be performed.  
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  • COVID- 19 Pandemic Salon/ Spa treatment Consent form

  • I, __________________, knowingly and willingly consent to have salon/ spa
    service(s) during the COVID-19 pandemic:
    I understand the COVID-19 virus has a long incubation period during which carries of
    the virus may not show symptoms and still be highly contagious. It is impossible to determine
    who has it and who does not, given the current limits in virus testing.
     I understand that due to the frequency of visits of other clients and characteristics of
    the virus, and the characteristics of salon services, that I have elevated risk of contracting the
    virus simply by being in the salon.
    I confirm that I am not presenting any of the following symptoms of COVID -19 listed
    below:

    Temprature above 98.7

    Shortness of breath

    Loss of sense or taste or smell

    Dry cough

    Sore Throat

    I confirm that if I present symptoms between now and my appointment that I will
    cancel.

    I also understand that I can be denied services if I show up with symptoms.

    I confirm that I have not been around anyone with these symptoms in the past 14
    days.

    I do not live with anyone that sick or quarantined.

    To prevent the spread of contagious viruses and to help protect each other, I
    understand that I will have to follow the salons strict guidelines.

    I understand that air travel significantly increases my risk of contracting my risk of
    contacting and transmitting the COVID-19 virus.

    I verify that I have not traveled outside the United States in the past 14 days to
    countries that have been affected by COVID-19

    I verify that I have not traveled domestically within the United States by
    commercial airline, bus, or train within the past 14 days

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  • Photo Release Form


  • Please be informed that all Weight Reduction treatments must be
    completed entirely before any enhancement treatments can be
    performed.

     

    I agree to allow my photos taken to be used for social media and marketing
    purposes.

     

    I decline and only want my photos to be used for recording my results of
    treatments.

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  • I, ______________________________, voluntarily consent to undergo Mesotherapy treatments provided by Newbody Formations or other certified body contourist, nurses, physician associates or qualified staff members employed by the practice. I understand that Mesotherapy can be used for many reasons and I want to have treatment for the following; Reduction of localized fat of __________________. I hereby consent to the Mesotherapy treatment of which I understand that more than one (1) treatment is required. I understand that the treatment requires many small injections around the area (s) to be treated. I understand that the administration of numbing cream may be used if deemed needed. I understand that there are some risks with any procedure. The following is the list of possible risks with Mesotherapy: 
  •  Bruising of the skin is very possible.
     Skin discomfort during the injections.
     Redness or swelling at the injection site.
     Lightening or darkening of the skin (transient or permanent)
     Itching and burning lasting 20 minutes to a few hours
     Scarring of the skin is unlikely.
     Nausea, dizziness and possible allergies to the Deoxycholic acid may
    occur.
     Skin infection is a possibility any time a surgical procedure is done.
    Arnica Montana tablets will be recommended to reduce bruising, swelling and
    inflammation. Start taking it a minimum of 3 days prior to scheduled treatment.
    By my signature, I acknowledge that I have been informed about the above
    medications and give consent to its use in my treatment. I know that the practice of
    medicine is not an exact science; therefore, no guarantee can be made as to the
    results of my treatments. I understand that this treatment is strictly for cosmetic
    purposes and will not be covered by insurance. I understand that I am responsible
    for all costs payable at the time of service.
    By my signature, I certify that I have thoroughly read and understand the contents of
    this form and the disclosures listed above were made to me.

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  • Mesotherapy Post-Treatment Instructions

  •  Immediately after the treatment, the most commonly reported side-effects were
    temporary redness, bruising and swelling at the injection site. These effects typically
    resolve within 5 to 10 days. Cold or ice compresses may be used immediately after
    treatment to reduce swelling.
     Continue taking Arnica Montana up to 7 days after each treatment to decrease
    bruising and inflammation.
     Apply 1% Hydrocortisone cream or Benadryl spray or gel on treated areas to
    reduce itching or redness.
     To minimize bruising, avoid Aspirin, Anti-inflammatory drugs, Gingko biloba,
    Garlic, Flaxseed Oil, Vitamin E, Alcohol, spicy food, salty food and cigarettes
    48 hours to 1 week after your treatment.
     It is normal to feel “firmness” in the injection site first day after treatment. In
    some cases, a lumpy formation can be felt on the injected area. If necessary,
    massage area gently 2-3 times a day up to 72 hours.
     Do not exercise for 24 hours after treatment. Avoid strenuous exercises,
    sunbathing or tanning.
     Apply sun block and protect skin from sunlight.
     For treatment of neck areas, sleep with head elevated (3-4 pillows), and wear some
    compression under chin (scarf or head band).
     Call us immediately if you start experiencing these symptoms or develop any
    persistent side effect

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  • Zoom Body Toning and Nutrition Coaching

  • Overview
    The Purpose of this Zoom Seminar is to educate women on dietary & physical wellness to
    develop a healthy lifestyle while maintaining a curvaceous & toned figure. In addition to
    dietary guidance we will also perform some key home workout movements to help them
    stay toned and shed unwanted body fat.
    Nutritional Coaching Overview
    These are the topics covered during the Nutritional Coaching Session
    1. Nutrition Foundations
    2. What to Eat to lose body fat and tone
    3. How to save money and eat healthy!
    Workout Overview
    This zoom workout session is designed to help women identify which workouts they can do
    at home to tone their body and burn unwanted fat.
    1. Dynamic Stretch to warm body up for session
    2. Lower Body Blast to have a round desirable glute
    3. Upper Body Sculpt to tone and define arms
    4. Core Burn to remove midsection belly fat and define abdominal

     

    Mindset Overview
    In this training we will cover the mindset required to take your fitness goals to the next
    level through strategy & execution
    1. Knowing your why
    2. Accountability
    3. Reward Based Results
    Investment: $50
    Bonus:
    I will also be offering 1 on 1 Complimentary Fitness Consultations (15 minutes) to each
    participant, to help customize dietary & fitness strategy

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