I hereby consent to have a Threads procedure performed on me.
I have received and read all the documents regarding threads procedure complications and undesirable effects, scarring and scars which complement information provided to me verbally from the time of the first consultation.
I am aware of the risk of complications related to this procedure. These complications could vary in gravity and could manifest during or immediately after the treatment, or within weeks after my return home. All invasive procedures carry the risk of infections. I authorize you hereby to take all necessary measures, should a problem arise during the procedure, to prevent or treat such complications.
You have informed me clearly and in detail about the surgical procedure, expected benefit, the possible outcomes and its inconveniences and limits. You have provided me with detailed and clear explanation and I have had enough time to think in order to make my decision and request to perform the procedure. I have had the opportunity to ask all additional questions regarding this procedure.
I have not explicitly withheld any information about my previous surgeries, medical problems and medications. In order to reduce the risk of bleeding, I will not take any anti-inflammatory drugs or drugs containing acetyl-salicylic acid (aspirin) for 10 days preceding the procedure. I have been informed of the risks of subsequent intervention if I do not comply.
I am expressly engaging to show up for postoperative consultations and to adhere with all necessary recommendations and treatments prescribed to me before, during and after the procedure. I am engaging to the clinic immediately and in person in case of any undesirable effect after my return home.
I am a competent consenting adult of at least 18 years of age (or my parent or legal guardian is giving consent on my behalf), and further:
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.
I hereby authorize and direct the doctors to perform the treatment on me.