I understand that the Sciton Profractional is intended for wrinkles, scars, and sun damaged skin and that clinical results may vary in different skin types. I understand that there is a possibility of rare side effects such as scarring and permanent discoloration as well as short term side effects such as reddening, mild burning, and temporary discoloration of the skin. These effects have all been fully explained to me

The Profractional is a quick and moderately comfortable laser procedure with little downtime, used for improving the overall appearance of your skin. Profractional uses a laser microbeam to treat thousands of pinpoint areas of your skin. Healing time is quick and downtime is short because only a fraction of the skin is directly treated with the laser.

Goal of treatment: Patient may discuss goals with the Physician and the Nurse. There can be no guarantee made as to anticipated results. Results will vary according to skin type and condition upon starting treatment. It is strongly recommended that a program of home skin care product usage be undertaken to further any gains made with the treatments. A series of 2-5 treatments at 6-12 week intervals are suggested, followed by a maintenance protocol of treatment and home care.

I understand that the treatment by Sciton Profractional system involves a fee, and the fee structure has been fully explained to me.

I understand that there are other options for treatment that are available in place of Profractional but I choose to proceed with this treatment.

I have read and understand this agreement and all my questions have been addressed and answered to my satisfaction. I agree to the terms of this agreement.