I hereby authorize ______________________, to perform the following procedure: SOFWAVE ULTRASOUND TECHNOLOGY I acknowledge that no guarantee has been given by anyone as to the results that may be obtained. I will follow all aftercare instructions as it is crucial to do so for good healing and to minimize the risk of complications. I understand that there are many types of treatment for fine lines and wrinkles and that each has its own benefits, risks and potential side effects. The treatment with the Sofwave System requires a non-invasive, dermatological procedure performed by a healthcare provider who is trained on the use of this product. By completing this Patient Consent Form, I am consenting to the treatment with the Sofwave System and acknowledging that I have read and understood the following points and all information contained in this form, and made an informed and careful decision to receive the treatment with the Sofwave System.
By signing below, I acknowledge that I have read the foregoing consent and agree to the treatment with its associated risks. I hereby give consent to perform this and all treatments with the above understood. I hereby release Yvonne Checa from all liabilities associated with any procedures.