• I confirm that I have requested a Micro needling Treatment to attempt to improve my facial expression lines, skin tone and texture and/or scarring.
• I acknowledge that this treatment is not an exact science, and no guarantees can be or have been made concerning expected results.
• I understand that several appointments may be necessary to reach the desired results.
• I understand that the risks, side effects, and complications are usually minimal.
• Occasionally I may experience redness, bleeding, temporary scarring, dryness and or discomfort. I have been advised of the risks involved in the treatment, the expected benefits, and alternative treatments, including no treatment at all.
• I agree that this constitutes full disclosure, and that it supersedes any previous verbal or written disclosures. I certify that I have read, and that I have had sufficient opportunity for discussion and to ask questions. I consent to this procedure today and for all subsequent treatments.

• 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.