Treatment Acknowledgment and Consent

I understand this treatment is an elective medical-cosmetic treatment and hereby acknowledge the following:

• I confirm that to the best of my knowledge the health history that I have supplied is correct and that there is no other medical information I need to disclose.
• I further understand that withholding any medical information may be detrimental to my health and safety during the treatment in which I agree to undertake.
• I understand that if there is any change in my medical history, it is my responsibility to advise the practitioner before further treatments are carried out.
• I have been informed in detail and understand possible risks, conditions, reactions, side effects associated with the treatment and I understand that the development of any reactions/side effects must be reported to the practitioner as soon as possible.
• I understand I may require a series of treatments to achieve the maximum cosmetic result. I certify that I will make available where possible any follow-up visits as my practitioner advises if required - approximately 2-6 weeks.
• The effects of treatment will vary with some patients than with others and I accept and understand that the goal of this treatment is improvement, not perfection, and that there is no written, implied, or verbal guarantee that the anticipated results will be achieved.
• I have understood and agree to follow above post-treatment advice given in the form of a leaflet in the knowledge that deviation can cause a disappointing result and, in some instances, can pre-dispose me to side effects and reactions to treatments.
• The treatment has been explained to me by the practitioner and I have had the opportunity to ask questions and that these have been answered to my satisfaction and I confirm that I have been allowed sufficient time to make a carefully considered decision to carry out the procedure and I confirm that I agree to the PRP procedure.