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INFORMED CONSENT
CELLUERASE

INFORMED CONSENT

I understand that I will be treated with Celluearse.

The indicated tool has been CE approved for use in Cosmetic cellulite removal treatment. 


The following complications may occur with the dermal filler injection procedure:
1. Risks: I understand there is a risk of bruising, redness, swelling, pain at the injection site, tenderness, itching, allergic reaction. These symptoms are usually mild and typically last a few days but can last up to a few months. In rare cases bruising can last several months and even be permanent.
2. Infection: Post treatment bacterial, viral and/or fungal infections can occur which in most cases are easily treatable but in rare cases a permanent scarring in the area can occur. Treatment for infection can be with Antibiotics prescribed by a Doctor/Nurse.

3. Infections are more common in those who have a history of acne and acne scarring and possible infection rate is higher.

I acknowledge that my technician has received training & certification in appropriate sanitation and hygiene techniques prior to performing any procedures. While the risk of infection from the procedure is extremely small, the possibility of such an occurrence cannot be totally prevented. Accordingly, I understand and accept the risk and release Mills Aesthetics from any and all liability related to the subject procedure, except instances involving gross negligence.

4. Effectiveness: Treatments are permanent and results should be seen in approx 7-10 days.
5. Treatments: I understand more than one treatment may be needed to achieve a satisfactory result. 
Allergic Reactions: 
6. There is a risk of scarring.

7. There is a risk of bruising
8.. I will follow all aftercare instructions as it is crucial I do so for healing.
9.. This list is not meant to be inclusive of all possible risks 
10. I understand there is no guarantee of results of any treatment and the regular charge applies to all subsequent treatments.
11. I understand that if I am not satisfied with any of the treatments I receive, I will contact Mills Aesthetics in the first instance with my concerns.

12 I confirm that I am not suffering from any Bacterial or Yeast Infections at the time of my treatment or at least 7 days after completing a full course of antibiotics.

16. The treatment I receive from Mills Aesthetics remains Private and I will not discuss with the public or on Social Media.
13. I understand that I am allowed to recommend Mills Aesthetics if I choose to but I will not defame Mills Aesthetics in any way publicly. 
14. I understand that I will have before & after images to compare results and these may be used by Mills Aesthetics for marketing purposes. 
15 I trust that the procedure being carried out, is my choice and I am in a good state of mind to make this decision.
16..I have read and understood the terms of service, cancellation and refund policy for treatment.

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By signing, I also agree to the following:

I have read and fully understand this agreement and all information detailed above. I understand the procedure and accept the risks. I agree I will assume the risk and full responsibility for any and all injuries, losses, side effects, or damages which might occur to me while I am undergoing this procedure. I do not hold Mills Aesthetics responsible for any of my conditions that were present, but not disclosed at the time of this skin care procedure, which may be affected by the treatment performed today.

 

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