INFORMED CONSENT

I understand that I will be injected with Hyaluronic Acid, also known as Dermal Filler by Injection.

The indicated dermal filler has been CE approved for use in Cosmetic treatments for Moderate to Severe Wrinkles & Lines, Improve Volume, Symmetry and Body Contouring.

I understand that Dermal filler treatment is temporary.

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, and raised bumps of skin (nodules). 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 can last anywhere from 4-6 months up to 18 months depending on the product that is used.
5. Treatments: I understand more than one injection may be needed to achieve a satisfactory result. 
Allergic Reactions: In rare cases, there may be an allergic reaction to the injection.
6. There is a risk of scarring.
7. I will follow all aftercare instructions as it is crucial I do so for healing.

8. As dermal fillers are not an exact science, there might be an uneven appearance of the face or body with some areas more affected by the fillers than others.
9. In most cases this uneven appearance can be corrected by more injections in the same or nearby areas. However in some cases this uneven appearance can persist for several weeks or months. 
10. This list is not meant to be inclusive of all possible risks associated with dermal fillers as there are both known and unknown side effects associated with any medication or procedure.
11. These dermal fillers should not be administered to a pregnant or nursing woman and if I find out I am pregnant before the procedure, I will cancel the treatment.
12. The number of units injected is an estimate of the amount of dermal filler required to add volume to the skin and give the desired appearance.
13. I understand there is no guarantee of results of any treatment and the regular charge applies to all subsequent treatments.
14. 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.

15 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.
17. 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. 
18. I understand that I will have before & after images to compare results and these may be used by Mills Aesthetics for marketing purposes. 
19 I trust that the procedure being carried out, is my choice and I am in a good state of mind to make this decision.
20.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.