CONFIDENTIAL CLIENT INFORMATION AND HEALTH HISTORY
Please select if you are, affected by or have any of the following conditions:
Cavitation Ultrasonic/RF: I was told the possible side effects of the treatment include local pain, skin redness (erythema), swelling (edema), damage to the natural skin texture (crust, blister, and burn), fragile skin and bruising. Although these effects are rare and expected to be temporary, any adverse reaction should be reported immediately.
Cancellations must be done, 24 hours prior to the reserved appointment time, to avoid fee charges. By signing this document, I (you) understand that any illicit or sexual suggestive remarks advances will result in immediate termination of the session. I (you) affirm that all information provided above is correct to the best of my knowledge.