I agree to undergo the treatment, as detailed below in this document. I was explained to and I understood the results, the chances and the course of the treatment. I confirm that I do not suffer from any of the above described conditions. I have had the opportunity to consider the following information, ask questions and have had these answered satisfactorily by (Physician/ therapist/practitioner). I understand that receiving the course of treatment is my choice. I was told about the possible side effects of the treatment including: excessive redness or swelling, itching, irritated skin, scratches, visible capillaries, sensitivity to touch, change of pigmentation, chance of transient skin break out such as pimples, allergic reaction. Although these effects are rare and expected to be temporary, any adverse reaction should be reported immediately. I confirm that I have read and understand the above information and consented to the treatment out of my own free will. I understand that at any time I may withdraw my consent and treatment will stop.I am aware of the 24-hour cancelation policy, If I fail to give 24-hour notice prior to my appointment, 50% of my service(s) will be charged on my credit card.I agree to be contacted periodically with special offers or services.
