Body Contouring Waiver - Shape it Up Contouring

Consent to Treatment Form Body Contouring / Sculpting

Please read before proceeding

Body Sculpting increases flow of both the lymphatic and circulatory systems, and it also helps with cleaning of the tissues.  The main use of body sculpting treatment is inch loss, diminishing of cellulite, and tightening of the skin.

Benefits:  Lose 1 to 3 inches per treatment with state-of-the-art equipment. Benefits are often immediate but may be delayed in some people.
For Best Results:  A series of 6 to 12 body sculpting treatments are recommended per each area, but some individuals may require more treatments to achieve maximum results. There should be at least 3 days (72 hours) between each treatment.  This is not a weight loss treatment, but an inch loss treatment.  The inches will only return if the client goes back to their old habits.  Eating the right types of food, proper exercise, and drinking glasses of water per day are always recommended.  For best results, it is recommended that your exercise within 4 to 6 hours of treatment and avoid sugar and alcohol for 48 to 72 hours after each treatment.

Precautions:  Body sculpting treatments are not recommended if you are pregnant, breast feeding, have a lymphatic disorder, acute illness, metal implants, pacemakers, or are currently being treated for active cancer.

Are you currently taking any medications or supplements?

Yes

If yes, please list.

Do you have any specific skin care problems / allergies pertaining to your face or body?

Yes

If yes, please list.

Have you ever had chemical peel, laser, microdermabrasion, or any skin resurfacing treatments?

Yes

Are you currently having your menstrual period?

Yes

Are you currently pregnant and/or nursing?

Yes

What skin care products do you currently use?

What temperature of water do you cleanse with? (Cold, Warm, Hot)

Client Name

First

Last Name

Last

Phone

Client Signature

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(951) 635-6304

Consent to Treatment Form Body Contouring / Sculpting

Please Read each and Click to check that you fully understand.

Murrieta Body Contouring
(951) 635-6304

(951) 635-6304

Consent to Treatment Form Body Contouring / Sculpting

Please Read each and Click to check that you fully understand.

Murrieta Body Contouring(951) 635-6304

Murrieta Body Contouring
(951) 635-6304