I give my informed and voluntary consent to Kai Life Clinic and/or its associates to take photographs and/or video of me before the procedure and after the. I understand that that these photographs and/or videos will be utilized and may be posted on social media (e.g., snapchat, Instagram, Facebook, websites) to show the transformation process to the general public which includes current and prospective patients. All patients will remain anonymous and any identifying features will be blurred out as best as possible, however, I also understand that in some rare circumstances the photographs and/or videos may display features that identify me.

I understand entirely that this authorization is completely voluntary. I understand that any disclosure of information has the potential of unauthorized disclosure and the information may not be protected by applicable UAE Law and/or confidentiality rules, Kai Life Cliniccannot guarantee, nor have liability should you disclose any identifying factors to a third party as they may not require to maintain your privacy.

We strongly recommend approval for medical documentation purposes at least.

I have read and understood the terms and condition of this authorization and have had an opportunity to ask questions about the use and disclosure of my information. By signing this consent, I hereby, knowingly, and voluntarily authorize Kai Life Clinic. to use my photographs and videos in the manner described above.

Approve for Medical Documentation in patient file.

Approve for Social Media Release.

DO NOT APPROVE ANY PHOTOS OR VIDEOS.