LED Technology Consent Form

LED Technology is a non-ablative procedure utilizing light emitting diode technology to treat a multitude of concerns including  cellulite, poor lymphatic drainage, unwanted fat, loose skin, scarring, and stretch marks.  It’s a natural treatment (photobiomodulation) much like the process of photosynthesis, using red wavelengths to stimulate your body’s own regenerative metabolism at the cellular level or to damage fat cells and cause their lipid contents to be released. 

LED energy can be combined with vacuum energy in a single treatment handpiece or it can be utilized as a single technology - housed within Lipo Laser paddles. 

The technology is non-invasive and should feel good - not produce pain or discomfort; however, if you experience any untoward effect, please report adverse reactions immediately.   We will provide protective eyewear that must be worn at all treatment sessions. 

LED technology is safe for most people, but certain contraindications do exist.  PLEASE ADVISE US  if you are pregnant or lactating, have been diagnosed with a seizure disorder or if you are taking any medication that causes photosensitivity, such as Accutane.   

Improvement is gradual and cumulative.  Before/After photos at your first and last treatments of your series of treatments can be beneficial to tracking treatment progress and may be used. 

Pro Tip:  We recommend the use of one ‘General Consent’ for each patient that, among other things, includes the general consent and release for photos to track progress, and in particular, photos to also use on your website and in your marketing.  These photos sell your services.

● If you use a General Consent that includes the consent for photos, you may omit the two sentences referencing photos above.

I consent to these photographs to track my progress if applicable.

I have read and understand all the foregoing statements about LED Technology.  I’ve had the opportunity to ask questions and understand there are alternatives to this treatment and elect to undergo this treatment.

Pro Tip:  We recommend you have the person obtaining the client’s consent print (legibly) as a witness.  If issues arise at a later date, you don’t have to rely on your memory