I hereby consent to and authorize Forever Confidence Aesthetics to perform the procedure I have voluntarily elected to undergo. The treatment, procedure, & service after the nature and purpose of this treatment has been explained to me.
I understand and acknowledge that there are risks involved with the treatment I will be receiving. Although it is impossible to list every potential risk and complication, I have been informed of possible benefits, risks, and complications, and I have had the opportunity to ask questions regarding these risks and other possible complications.
I also recognize there are no guaranteed results and that independent results are dependent upon age, skin condition, diet, and lifestyle and that there is a
possibility I may require further treatments of the treated areas to obtain the expected results at an additional cost.
I have read and understand the post-treatment home care instructions. I understand how important it is to follow all instructions given to me for post treatment
care. In the event that I may have additional questions or concerns regarding my treatment of suggested home product/post-treatment care, I will consult with Forever Confidence Aesthetics immediately if I have any questions or concerns.
I have, to the best of my knowledge, given an accurate account of my medical history, including all known allergies or prescription drugs or products I am currently ingesting or using topically.
Given the above, I understand that response of treatment varies on an individual basis and specific results are NOT guaranteed. Therefore, in consideration for any treatment/procedure/service received, I agree to unconditionally defend and hold harmless and release Forever Confidence Aesthetics and the individual that provided my treatment from all liability, for any condition or result, known or unknown, that may arise as consequences of any treatment, procedure, & services that I received.
Petitions, and causes of actions with I, my heirs, representatives, executors, or any other persons may make while acting on my behalf or on behalf of my state. I have read and fully understand this agreement and all information detailed above. I understand the procedure and accept the risks. I agree I will assume the risk and full responsibility for any and all injuries, losses, side effects, or damages which might occur to me while I am undergoing treatment, procedure, & service. I do NOT hold Forever Confidence Aesthetics, responsible for any of my conditions that were present, but not disclosed at the time of this skin care or body treatment procedure or services, which may be affected by the treatment performed today.