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CONSENT FORM

Laser Lipo

About Laser Lipo

About Laser Lipo:

The AW3® Laser Lipo fat reduction treatment is a method of removing fat/cellulite. Everyday lifestyle, diet and lack of exercise can influence production of fat and the body appearance. Treatments using the AW3® Laser Lipo System will not cure any medical conditions or alter the natural production of fat to your body.

The purpose of the treatment is to achieve improvement in the appearance of the body by removing unwanted fat and reducing the area in size. An exact result cannot be measured and results vary with all customers.  As part of the programme, regular exercise and good diet will aid the treatment to work more effectively.

I understand that excessive heat should be avoided for 48 hours and that exposure to the sun, including sun beds, must be avoided for 14 days before treatment and 14 days after treatment. A sun block of SPF 30+ must be used on the treated skin areas, otherwise it might be possible that blotchy skin pigmentation, hyper- or hypo-pigmentation and dark or light spots on the skin might occur.

Other potential risks include, crusting, itching, burn, scabbing, blistering.

Side effects may also include temporary redness and a mild ‘sunburn’ like effect that may last a few hours to a few days.

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I, hereby authorise and direct any associates or assistants of Bodyvision Clinic to perform Laser Lipo procedure.

I fully understand that this treatment is purely elective and not medically necessary.

I understand that an exact result cannot be measured and results will vary with all customers.

I understand that I may require multiple treatments.

I fully understand that results are not guaranteed.

By signing this consent form, I confirm I am over the age of 18 and have read and fully understand the contents of this consent form.

I have had the opportunity to ask questions and receive answers regarding procedure.

I agree to pay in full for our discussed treatment and understand that there will be no refunds for any performed services.

I understand that I have the right to refuse the proposed procedure at any time prior to its performance.