Consent Form.

Lone Star Body Sculpting

Consent Form

I...

First name

Last name

consent to receiving body sculpting services to be performed by Lone Star Body Sculpting.

Please read and check the box next to the following statements:

I consent to receiving the requested body sculpting services.

I consent that I am 18 years of age or older.

I understand that this is not a weight loss treatement and that inches lost are circumferential.

I understand that results are not guaranteed and I must adhere to all before and after care instructions.

I undersatnd that I am unable to partake in select body sculpting services if I have any of the following conditions: Cancer, Cardiovascular Disease, Pacemaker, Pregnant, or Skin Allergies.

I understand that I may experience redness, bruising, skin irritation, or swelling.

I have read and consent to the statements above. I understand the risks associated with the body sculpting treatments and will not hold the aesthetician nor associated company responsible or liable for any injuries, side effects, or damanges that may occur from receiving the treatements.

Patient's Signature

Signature Date

Consent Form.

Lone Star Body Sculpting

Ase'Moon Studio

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