I understand that this procedure cannot guarantee 100% expected results.

I understand that post-operative care is necessary to fully achieve your expected goal. I confirm that it is my responsibility to follow the treatment and attend the follow-up appointments after the procedure.

I permit the clinic to take photographs and videos of the procedure for educational purposes only.

I allow this clinic to use my photographs for "before and after results" for marketing and advertising purposes.

I hereby release this clinic from any indemnification and hold them harmless against physical damage, personal injury, or accidents that may occur during and after the procedure.

I confirm that all information I provided in this form is accurate and true.