PURPOSE OF CONSENT:
To provide written information regarding the risks, benefits, and alternatives of the treatment. It is important that the patient fully understands the treatment and it's process prior to moving forward with the treatment. Before signing the consent, the patient should ask any of the questions regarding the treatment.
Nonsurgical body contouring is also known as nonsurgical fat reduction. There are a variety of nonsurgical fat reduction procedures. These procedures reduce or remove stubborn pockets of fat to contour and shape different areas of the body. Most nonsurgical fat reduction treatments are based on one of these four principles:
-Cryolipolysis, or controlled cooling, uses freezing temperatures to target and destroy fat cells.
-Laser lipolysis uses controlled heating and laser energy to target fat cells.
-Radiofrequency lipolysis uses controlled heating and ultrasound technology to target fat cells.
-Injection lipolysis uses injectable deoxycholic acid to target fat cells.
Nonsurgical body contouring procedures aren't intended to be weight loss solutions. Ideal candidates are close to their desired weight and want to eliminate stubborn pockets of fat that are resistant to diet and exercise. With most body contouring procedures, your body mass index shouldn't be over 30.
Body sculpting treatments are not recommended if you are pregnant, breastfeeding, have a lymphatic disorder, acute illness, metal implants, pacemakers, or are currently being treated for active cancer.
I acknowledge that:
Refund & Re-Schedule Policy:
By signing this form, I declare that I am of legal age and give my full consent to the Body Contouring treatment. I have fully read and understand the contents provided herein and I assume the risks involved, including any complications and benefits resulting from the foregoing. I have had the opportunity to ask questions and clarifications and by which I have received answers to my satisfaction. I am executing this consent with full knowledge and responsibility to my actions.