Informed Consent for Medical Aesthetic Treatments

Please read carefully before signing:

1. Nature of Treatment

I understand that I am undergoing a cosmetic/medical aesthetic procedure. The nature, purpose, and potential risks of the procedure have been explained to me by qualified medical professionals.

2. Risks and Complications

I acknowledge that all medical procedures carry inherent risks. Possible risks may include but are not limited to:

• Bruising, swelling, or redness at treatment site
• Allergic reactions to medications or products
• Infection or scarring
• Asymmetry or uneven results
• Temporary or permanent changes in skin sensation
• Adverse reactions requiring medical intervention

3. Pre-Treatment Instructions

I agree to follow all pre-treatment instructions provided by the clinic, including but not limited to:

• Disclosure of all medications and supplements
• Avoiding certain medications or products as instructed
• Arriving with clean skin, free of makeup
• Notifying staff of any changes in health status

4. Post-Treatment Care

I agree to follow all post-treatment care instructions and understand that proper aftercare is essential for optimal results and minimizing complications.

5. Results and Expectations

I understand that:

• Results may vary from person to person
• Multiple treatments may be necessary
• Results are not guaranteed
• Touch-up treatments may be required
• Final results may take time to appear

6. Photography and Documentation

I consent to pre- and post-treatment photographs for medical records. I understand these images will be kept confidential and used only for medical documentation unless I provide separate written consent for marketing purposes.

7. Medical Information

I certify that I have provided complete and accurate information about my medical history, current medications, allergies, and health conditions. I understand that withholding information may affect my treatment outcome and safety.

8. Payment and Cancellation

I understand that:

• Payment is due at time of service
• Cancellations require 24-hour notice
• Late cancellations or no-shows may incur fees
• Cosmetic procedures are not covered by insurance

9. Privacy and HIPAA

I acknowledge that I have received and reviewed the clinic's Notice of Privacy Practices and understand how my medical information will be used and protected under HIPAA regulations.

10. Questions and Communication

I have had the opportunity to ask questions about my treatment and all my questions have been answered to my satisfaction. I understand I may contact the clinic at any time if I have concerns.

11. Voluntary Consent

I voluntarily consent to the treatment and acknowledge that no guarantees have been made regarding the outcome. I release MOI Beauty Med Spa, its doctors, staff, and associates from liability for any complications that may arise, provided services are performed with reasonable care and skill.

By signing below, I acknowledge that I have read, understand, and agree to all terms and conditions stated above.