Client Consent Form

I acknowledge any risks associated with performing this procedure and have been informed of possible post-procedure side effects.

Any concerns I have with this procedure have been addressed by my service provider. I understand that my service provider will take necessary precautions to prevent risks from occurring during the procedure and release them from all liability when assuming these risks.

I will adhere to all post-procedure recommendations made by my service provider, to ensure best quality of service.

I certify that the above information is correct and that I have disclosed all conditions that may affect my quality of service and risks associated with my service provider. I have not withheld any information that may increase risks associated with agreed services.