I am aware that the percentage of improvement of the defect to correct, the entity, the tolerability of the substance and its duration, the symmetry of the result, do not only depend on the techniques used and on the filling substances used, but also on the organism's response. I declare that I am aware that the practice of Medicine and Surgery does not constitute the expression of an exact science and I am aware that no warranty may be given to me in relation to the achievement of the aims anticipated by the procedure proposed. In case of dispute of the medical operation or for any controversy concerning the professional performances carried out, regarding the abovementioned method, the parts will renounce from judicial actions by now and will opt for an arbitration. I also understand the possibility that, during the course of the operation, unpredictable and unexpected situations may be verified, such to request the actuation of procedures not expressly stated in this document or the modification of the part for which this document has been elaborated. These procedures, necessary to bring back the general or local situation to optimal conditions, will be realized with the only aim of completing the treatment in the best way. I therefore authorize to realize these procedures in case, according to his/her experience, training and judgment, they were to be retained necessary, always operating with diligence, prudence and ability.
I declare that I have received all the necessary and exhaustive information concerning this form, that I have asked all the questions that I considered opportune and that I have received clear and thorough responses that I have understood and that on the basis of the information and clarifications received, I accept the treatment proposed.
I AUTHORIZE:
Bella Day Spa LLC to take pre-treatment pictures that will be exclusinvely used for popular/scientic purposes.
I AUTHORIZE:
Bella Day Spa LLC to realize the treatment proposed and described above.
I confirm that I have read and understand the abovementioned.
I confirm that I have had the possibility to ask all the questions that I considered necessary.
Taken note of the situation illustrated, I ACCEPT the medical procedures proposed