• I understand that the device used for dermatologic procedures requiring ablation of soft tissue and skin resurfacing, of which I am consenting to be a patient receiving treatment.
• I understand that clinical results may vary depending on individual factors, including but not limited to medical history, skin type, patient compliance with, and post-treatment instructions and individual response to treatment.
• I understand that there is a possibility of short-term or long-term effects such as reddening, swelling, blister formation, temporary discoloration of the skin, as well as the possibility of rare side effects such as burn, scarring and permanent discoloration. These effects have been fully explained to me.
• I understand that the treatment involves a series of treatments, and the fee structure has been fully explained to me.
• I certify that I have been fully informed of the nature and purpose of the procedure, expected outcome and possible complications, and I understand that no guarantee can be given as to the results obtained. I am fully aware that my condition is of cosmetic concern and that the decision to proceed is based solely on my expressed desire to do so.
• I conform that I have informed the staff regarding any current or past medical condition, Diseases or medication taken, as well as much past and planned exposure to sun, sunbed, and tanning creams.
• I certify that I have been given the opportunity to ask questions and that I have read and fully understand the contents of this consent form.

• Pre and post treatment instructions have been explained to me.
• I have had the opportunity to ask questions, and all my questions have been answered to my satisfaction.
• I declare that while completing the medical questionnaire, I have answered the information related to my personal medical history questions completely and I have not withheld any information.
• I must notify the clinician if my medical history changes prior to subsequent treatments.
• I consent to clinical photographs being taken of my treated areas for my personal health record only.
• There are no refunds for services rendered and/or after a year from purchase and not used.
• The treatments I receive here are voluntary and I release KAI LIFE CLINIC, my doctors, nurse and/or my technician from liability and assume full responsibility thereof for this appointment and future appointments
• My signature below constitutes my acknowledgment and understanding of all this information.