Please review the benefits, risks, and contraindications of non-invasive radio frequency (RF) treatment. Complete the form to provide your informed consent and release of liability.

WHAT IS NON-INVASIVE RADIO FREQUENCY Non-invasive radio frequency (RF) is a cosmetic treatment that uses controlled heat energy to stimulate collagen production, tighten skin, and improve overall skin texture and tone. This treatment is considered non-surgical and requires a series of treatments for optimal results. EXPECTED BENEFITS I understand the potential benefits may include: • Skin tightening and firming • Improved skin texture and tone • Temporary reduction in the appearance of fine lines or mild laxity • Collagen stimulation over time I understand that results vary from person to person and are not guaranteed. POSSIBLE SIDE EFFECTS & RISKS I understand that I may experience: • Temporary redness • Mild swelling • Warmth or tingling sensation • Skin sensitivity • Rare risk of burns, blistering, or pigmentation changes I understand that following all pre- and post-care instructions reduces risks. CONTRAINDICATIONS I confirm that I do NOT have any of the following unless disclosed below: • Pregnancy • Pacemaker or implanted electrical device • Metal implants in treatment area • Active cancer or undergoing cancer treatment • Severe skin disease, infection, or open wounds • Recent injectables, laser, or aggressive treatments in the area • Autoimmune or uncontrolled medical conditions affecting healing Medical conditions / medications to disclose: TREATMENT ACKNOWLEDGEMENT I understand: • Multiple treatments are typically required for best results • Results develop gradually over several weeks • Maintenance treatments may be recommended • This treatment is cosmetic and not medical I have had the opportunity to ask questions and all questions were answered to my satisfaction. LIABILITY RELEASE I voluntarily consent to receive non-invasive radio frequency treatment. I release the provider, business, and staff from liability for expected or unforeseen outcomes when treatment is performed according to standard professional practice