Skin Patient Consent Form It is important you read through the patient consent form and thoroughly understand it before you complete and submit the form. All questions are mandatory before the commencement of any treatment, if there are any questions that are unanswered - you will not be able to continue. Treatments Covered: * Chemical Peels * Facials * Microneedling and Meso Needling with Active * Exosomes Patient Details Full Name: (required) Date of Birth (required) Contact Number (required) Email: (required) Address: (required) MEDICAL HISTORY Please provide the following information if this applies to you: * Medical history or health concerns: * Medications you are taking: * Allergies: * Previous Cosmetic Surgery: The following questions are mandatory and require a YES OR NO. • Do you currently have any skin disorders or conditions, including but not limited to active acne, rosacea, psoriasis, herpes, open wounds, keloid scarring, skin infections, skin cancer, or autoimmune disorders, that may increase the risk of complications with the treatment? People with active acne, rosacea, psoriasis, herpes, open wounds, keloid scarring, skin infections, skin cancer, or autoimmune skin disorders should avoid these treatmentss due to increased risk of complications. NoYes • Do you have any hormonal disorders, such as Myasthenia Gravis, neurological disorders, Hashimoto's Disease, Eaton-Lambert syndrome, Bell's palsy, Crest syndrome/Scleroderma, Rheumatoid Arthritis, Epilepsy, Multiple Sclerosis, muscular weakness, Myasthenic syndrome, or an autoimmune disease like Lupus? NoYes • Do you have a history of blindness in one eye, cancer, heart disease, hypertension, hypotension, diabetes, kidney disorders, thyroid illness, chronic fatigue, hepatitis, HIV, thrombosis, phlebitis, hemophilia, or hypoglycemia? NoYes • Do you suffer from serious cardiac, renal, or liver disease? NoYes • Have you had any surgery in the past 6 weeks? NoYes • Are you pregnant, breastfeeding, intending to become pregnant, or undergoing IVF treatment? NoYes • Are you currently under investigation by your GP or a specialist for any health concerns? NoYes • Are you allergic to local anesthetics, blood products, or bee stings? NoYes • Are you currently taking any of the following medications: blood thinners, aspirin, herbal supplements, fish oils, NSAIDs, Roaccutane, or antibiotics? NoYes • Have you ever experienced a skin allergic reaction, hives, excessive swelling, or bruising from other facial injection procedures (e.g., PDO threads, PRP, HA fillers)? NoYes • Do you have any metal stents or implants in the area to be treated? NoYes • Have you undergone any surgical cosmetic procedures in the face or neck? NoYes If you any of the above medical conditions, please urgently alert the team as soon as possible as you may need to get assessed by your GP to ensure your safety of proceeding with the treatment. If any of these conditions are deemed serious or not suitable for treatment, the staff at body contour studio will refuse to conduct your treatment. FINANCIAL CONSENT I acknowledge that cosmetic non-surgical procedures such as facials, chemical peels, Exosomes, NCTF Boost HA 135, mesotherapy, and microneedling require ongoing treatments for optimal results, which can vary from person to person. A treatment plan typically involves multiple procedures, which may not be limited to those listed above. I understand that these cosmetic procedures are not covered by Medicare or private health insurance, and all expenses related to them will be my responsibility. I acknowledge that "before and after" images represent genuine results from actual patients, but individual outcomes may differ. I confirm that no guarantees have been made or promised regarding the results, as these can vary significantly among individuals. I also confirm that no guarantees were given concerning the estimated duration of treatment or the number of treatments needed, as individual experiences and results can differ. AVERAGE RECOMMENDED TIMEFRAMES: * Microneedling and Mesotherapy: every week (pricing varies by treatment area) * NCTF Boost HA 135: every week (pricing varies by treatment area) * Chemical Peels and Facials: every two weeks (pricing varies by treatment area) * Exosomes: every two weeks (pricing varies by treatment area) CONFIRMED THE ABOVE PATIENT CONSENT: I acknowledge and accept that: * The treatment(s) performed are for cosmetic reasons and the result(s) can therefore only be assessed subjectively. * While I have been advised as to the probable result, this can in no way be interpreted as a guarantee. * Several appointments may be required to complete my desired outcome. * Whilst complications from the treatment(s) are uncommon, they do sometimes occur. * No guarantees of any nature can be made as to the result of the treatment(s). * The complications and risks have been discussed with me in full. * There are alternatives to the treatment(s) available such as accepting my present condition. * I am undergoing the treatment(s) of my own volition. * My treating Registered Health Practitioner can refuse to complete any treatment(s) that I request, provided my treating Registered Health Practitioner has assessed my request and reasonably determined it is not appropriate to conduct such treatment(s). * The expert advice given by my treating Registered Health Practitioner about the recommended dosage(s) or treatment(s) is subject to my personal circumstances. I accept that recommended dosage(s) or treatment(s) vary from person to person. * Should I require any additional dosage(s) or treatments I will be charged an additional fee. * Cosmetic procedure(s) may cause me to suffer mental health symptoms or exacerbate any existing mental health conditions from which I may suffer. The mental health symptoms/conditions relevant to this include, but are not limited to, Body Dysmorphia, Anxiety, Depression, decrease of Self Esteem, Obsessive Compulsive Disorder, and/or Post Traumatic Stress Disorder. I acknowledge that if I experience any mental health conditions and/or symptoms following the treatment(s), I am to consult with my General Practitioner. * I have been given the opportunity to seek alternative medical advice and have been given sufficient information about the treatment(s) and product(s) to be used during my treatment(s). * I have been given post care treatment instructions, patients information and contact details. * I have read the patient instructions thoroughly and was given the opportunity to raise any concerns that I may have. * I have flagged any conditions that I may have which is a contraindication for the treatments. * If I feel pain, experience any side effects, or have any other issues, I will immediately contact my cosmetic nurse. * I confirm and understand that in the event of an adverse event, complication, or side effect, I may be required to take time off work and Body Contour Studio will not be liable as I understand all the risks and side effects associated with the treatments. * I confirm and understand that in the event of an adverse event, complication or side effect further treatment may be required and will incur further financial expense. In the event a specialist is required, the fees may present from $250 per hour up to $5000 or more. I confirm that Body Contour Studio will not be liable as I understand all the risks and side effects associated with the treatments. * In the event of an adverse event, complication, or side effect, in the event of adverse events, complication or side effect, recovery times and care requirements will vary from person to person. * Cosmetic Procedures are not covered by Medicare or private health insurance. * I understand that I may get a condition called paradoxical adipose hyperplasia and liposuction may be required. As such, I will release Body Contour Studio and forever discharge Body Contour Studio (including its officers, members, owners, employees, and agents) from all damages, costs, expenses, liabilities, causes of action, claims and demands, of whatever character, in law or in equity, whether known or unknown, direct or indirect, asserted or unasserted, and whether or not on account of myself. * I have read and fully understand the above information and consent to undergo today's cosmetic procedure and for any subsequent treatments as per the nurse performing the procedure. * The health practitioner has discussed other options for treatment and the option of not having the procedure is discussed. * I agree and consent to my before and after images to be accessed by the treating nurse, and by any Medical Team. My images will be stored in patient records for reference. * I consent to my patient notes to be released to the any Medical Team or any specialists if required. * My patient notes will be stored in patient records for reference. CONFIRMED THE ABOVE WAIVER AND RELEASE OF LIABILITY In consideration of participating in any treatments or services offered by Hint Venture Capital Pty Ltd, operating as Body Contour Studio (referred to as the "Clinic"), located at 38 Burringoa Crescent Colebee NSW 2761 Australia and 176A Burwood Road Belmore NSW 2192 Australia, I, the undersigned participant, hereby acknowledge and agree to the following: * Assumption of Risk: I am aware that the treatments and services provided by the Clinic carry inherent risks and that injuries, accidents, or complications may occur during or as a result of these treatments. I voluntarily assume all risks associated with participating in the treatments or services offered by the Clinic. By participating in any of the treatments offered at Body Contour Studio (referred to as the "Activity"), I acknowledge the potential risk of injury. In consideration for the privilege of participating in the Activity, I willingly and voluntarily enter into this waiver and release of liability. I hereby waive any and all rights, claims, or causes of action arising from my participation in the Activity. Furthermore, I release and forever discharge Hint Venture Capital Pty Ltd, Body Contour Studio, their affiliates, managers, members, agents, attorneys, staff, volunteers, heirs, representatives, predecessors, successors, and assigns from any physical or psychological injury, including illness, paralysis, death, damages, economic loss, or emotional loss that may occur as a direct result of my involvement in the Activity. This release encompasses any injuries or losses sustained during travel to and from events related to the Activity. * Release and Waiver: I hereby release, waive, discharge, and covenant not to sue Hint Venture Capital Pty Ltd, Body Contour Studio, their affiliates, managers, members, officers, directors, employees, agents, contractors, and representatives (collectively referred to as the "Released Parties"), from any and all claims, liabilities, demands, actions, causes of action, costs, and expenses, including but not limited to medical expenses, attorney fees, and court costs, arising out of or in any way connected with my participation in the Clinic's treatments or services. This release applies to any and all claims, whether known or unknown, arising from the negligence, carelessness, or other acts or omissions of the Released Parties. * Indemnification: I agree to indemnify, defend, and hold harmless the Released Parties from and against any and all claims, liabilities, demands, actions, causes of action, costs, and expenses, including but not limited to medical expenses, attorney fees, and court costs, arising out of or in any way connected with my participation in the Clinic's treatments or services. This includes claims brought by third parties, as well as claims arising from my own acts or omissions. I agree to indemnify and hold Hint Venture Capital Pty Ltd, Body Contour Studio harmless against any claims, suits, or actions, including liability, medical negligence, damages, compensation, or other related costs, brought by me or anyone acting on my behalf. If litigation arises from any claims made by me or on my behalf, I will reimburse Hint Venture Capital Pty Ltd, Body Contour Studio for any expenses incurred. * Medical Clearance: I certify that I am physically and mentally fit to participate in the treatments or services provided by the Clinic. I have not been advised by a qualified medical professional to refrain from participating in these treatments or services. * I acknowledge that the treatments offered at Body Contour Studio can result in permanent changes and adverse consequences. I assume full responsibility for any personal injuries that may occur as a result of these treatments. In exchange for receiving these treatments, I release Body Contour Studio, including its officers, members, owners, employees, and agents, from any and all damages, costs, expenses, liabilities, causes of action, claims, and demands, whether known or unknown, direct or indirect, asserted or unasserted, arising from the treatments I have requested. This release extends to all parties whose claims may arise in connection with the treatments, including spouses, heirs, and children, whether born or unborn. Any legal claims related to the treatments will be governed by New South Wales (NSW) law. I agree to indemnify, hold harmless, and defend Body Contour Studio, including its officers, members, owners, employees, and agents, against any third-party claims, causes of action, damages, judgments, costs, or expenses, including attorneys' fees and other litigation costs, arising from the treatments I have requested. * By signing this agreement (consent form), I confirm that I am at least 18 years old. I understand that the procedures involved in these treatments stimulate permanent changes and carry potential adverse consequences. I acknowledge that the procedures are purely for cosmetic purposes. I have read and fully comprehend this consent and procedure form. I consent to the indicated procedure(s) and accept full responsibility for any complications or outcomes that may arise during the procedures performed at my request. I understand that signing this agreement entails relinquishing certain legal rights. * Voluntary Participation: I acknowledge that my participation in the Clinic's treatments or services is voluntary and that I have chosen to participate despite the known risks and potential complications. * Governing Law: This waiver and release of liability shall be governed by and construed in accordance with the laws of the jurisdiction in which the Clinic is located. * Severability: If any provision of this waiver and release of liability is deemed invalid or unenforceable, the remaining provisions shall remain in full force and effect. I have read this waiver and release of liability, fully understand its terms, and voluntarily agree to be bound by it. I acknowledge that I am signing this document freely and without any inducement or assurance of any nature. I acknowledge that I have carefully read and fully understand this "Waiver and Release." I explicitly agree to release and discharge Hint Venture Capital Pty Ltd, Body Contour Studio, and all their affiliates, managers, members, agents, attorneys, staff, volunteers, heirs, representatives, predecessors, successors, and assigns from any claims or causes of action. I voluntarily waive any right I may have had to bring a legal action against Hint Venture Capital Pty Ltd, Body Contour Studio for personal injury or property damage. In the event that I require medical care or treatment due to any side effects or adverse effects, I accept full financial responsibility for any costs incurred as a result of such treatment. Arbitration It is understood that any dispute arising as to any malpractice of any of the treatments provided at Body Contour Studio shall be decided by a neutral arbitrator. Any arbitration proceeding will be governed by New South Wales (NSW) arbitration act, the fees for the arbitrator will be split pro-rata among the parties and each party will be responsible for their own lawyers’ fees and costs. Any action to collect fees from the client/patient for the treatments performed may be brought in any court located in New South Wales (NSW) and the prevailing party in such collection action shall be entitled to recover its reasonable lawyers’ fees and costs. Filing of any action in any court to collect any fee from the client/patient shall not waive the right to compel arbitration of any malpractice claim. CONFIRMED THE ABOVE TREATMENTS Microneedling and Mesoneedling with Actives I have been informed about the microneedling and mesoneedling procedures, which enhance the appearance, texture, and overall quality of my skin by stimulating collagen production, neovascularisation, and the release of beneficial growth factors for skin and scalp health. The Toskani Mesotherapy with Neopen® by ToskaniMed can effectively address various skin concerns, including, but not limited to, hyperpigmentation, dehydration, stretch marks, scars, rosacea, and hair loss. This technique involves using small, sterile needles to create micro-channels in the dermis, facilitating collagen and elastin synthesis while enhancing the absorption of active ingredients, customised actives will be infused into your skin. To achieve optimal results, I understand the importance of strictly following both in-clinic treatments and at-home care as explained by my doctor or therapist. I acknowledge that there are inherent risks involved, including common side effects such as pain, itching, temporary swelling, redness, bruising, and skin flaking. Other potential side effects may include, but are not limited to, tightness and dryness of the skin, transient darkening of pigmentation, allergic reactions, sensitivity to products applied after the treatment, and reactivation of cold sores. Additionally, less common side effects may include infection, scarring, systemic hypersensitivity, allergic granuloma formation, the development of milia and acne, and prolonged redness or irritation. I understand the importance of adhering to the recommended pre- and post-treatment care instructions provided to me. I recognise that disclosing my complete medical history, including any allergies, medications, previous herpes simplex virus infections, and family or personal history of keloids, is crucial for the success of the treatment. I confirm that I have read and understood the contents of this document, and my questions about the microneedling and mesoneedling procedures, including their risks, benefits, and alternatives, have been thoroughly addressed by my healthcare provider. By signing below, I grant my unrestricted informed consent for the microneedling and mesoneedling procedures, including the use of photographs for diagnostic purposes, which will remain the property of the clinic for my medical records. I have read the information regarding Microneedling and Mesoneedling with Actives and understand the treatment risk and side effects. Chemical Peels and Facials I have been informed about the facial and chemical peel procedures, both of which are designed to enhance the appearance, texture, and overall quality of my skin. The facial treatment involves various techniques and products tailored to my skin type, including cleansing, exfoliation, extraction, hydration, and the application of masks, which promote relaxation and rejuvenation while addressing specific skin concerns. The chemical peel involves applying a chemical solution to exfoliate the outer layers of the skin, promoting cell turnover and revealing smoother, more radiant skin beneath. Both treatments can effectively address various skin issues, including fine lines, wrinkles, acne, hyperpigmentation, sun damage, and uneven skin tone. To achieve the best results, I understand the importance of adhering to the recommended pre- and post-treatment care instructions provided to me. I acknowledge that there are inherent risks involved. Common side effects of facials may include redness, sensitivity, acne breakouts and irritation, while chemical peels may lead to redness, peeling, dryness, and sensitivity of the treated area. Other potential side effects for both treatments may include, but are not limited to, temporary swelling, itching, burning sensations, and changes in pigmentation, such as hyperpigmentation or hypopigmentation. Less common complications can include scarring, infection, burns and allergic reactions to the products or chemical solutions used. I recognise that disclosing my complete medical history, including any allergies, medications, and previous skin treatments, is essential for ensuring the safety and effectiveness of both the facial and chemical peel procedures. I confirm that I have read and understood the contents of this document, and my questions regarding these treatments, including their risks, benefits, and alternatives, have been thoroughly addressed by my healthcare provider. By signing below, I grant my unrestricted informed consent for the facial and chemical peel procedures, including the use of photographs for diagnostic purposes, which will remain the property of the clinic for my medical records. I have read the information regarding chemical peels and facials and understand the treatment risk and side effects. NCTF I have been informed about the NCTF® Boost treatment, which uses NCTF® 135HA, a polyrevitalising solution that improves skin quality by creating an optimal environment for fibroblast activity. This treatment stimulates the production of collagen, elastin, and hyaluronic acid without altering facial features or expressions. Containing free hyaluronic acid (HA), NCTF® 135HA helps smooth fine lines, restore radiance, deeply nourish the skin, and improve the density of the dermis. M-HA® 10 is a visco-elastic solution aimed at restoring lost hyaluronic acid due to skin ageing, improving hydration, radiance, and elasticity, and serving as a filling agent for small wrinkles. While this treatment is designed to enhance firmness, elasticity, and overall skin quality for up to six months, I understand that there are potential risks. Common side effects may include, but are not limited to, mild to moderate discomfort, redness, swelling, bruising, bleeding, and inflammation at the injection sites. I also acknowledge the risk of infection, temporary skin irritation, or allergic reactions, particularly for individuals sensitive to hyaluronic acid or other ingredients. Less common side effects may include the development of nodules, granulomas, prolonged redness or swelling, and pigmentation changes. Rare but more serious complications can arise, such as vascular occlusion, which may block blood flow, leading to tissue damage, necrosis. Additionally, I understand that scarring, keloid formation, and acne breakouts are possible risks, particularly for those with a personal or family history of such conditions. In rare cases, these complications could result in permanent changes to the skin, and I have been advised to seek medical help immediately if any adverse reactions occur. I recognise the importance of disclosing my full medical history, including any known allergies, medications, and pre-existing conditions such as cold sores, granulomas, skin infections, keloids, or a history of acne, as these may affect the safety and outcome of the procedure. I have read and understood this document, and my questions regarding the NCTF® Boost and FillMed Skin Booster treatments, including their risks, benefits, and alternatives, have been answered by my healthcare provider. I give my informed consent for the treatment, including the use of photographs for medical records, and release the clinic and its staff from any liabilities associated with this procedure. I have read the information regarding NCTF Boost HA and understand the treatment risk and side effects. EXOSOMES Exosomes are small extracellular vesicles that play a crucial role in cellular communication and regeneration. They are involved in transporting proteins, lipids, and genetic material between cells, promoting healing and tissue repair. In cosmetic procedures, Exosomes are used to enhance skin quality by delivering growth factors and nutrients that stimulate cellular activity, helping to improve the overall appearance of the skin. I have been fully informed about the nature of the Exosomes procedure and understand that, while there may be benefits, all procedures carry inherent risks. Possible side effects include but not limited to pain, temporary skin redness, swelling, or bruising at the treatment site, slight discomfort during the application of the treatment, infection, sensitivity, allergic reactions, dissatisfaction with results based on individual skin characteristics, the need for further procedures, and unforeseen complications that may emerge over time. Other side effects are hematoma, Scarring is an inherent risk with all invasive procedures; although normal wound healing is expected, abnormal scars can form, potentially impacting aesthetics and functionality. I also understand that the results may not meet my expectations, leading to visible deformities, loss of function, or other undesirable outcomes. Allergic reactions, while rare, can happen, particularly to specific components of Exosomes or materials used during the procedure, and may necessitate further treatment. Symptoms indicating infection, such as high fever, increased redness, swelling, or worsening pain, must be reported to my clinician immediately for appropriate care. I acknowledge that I have discussed these risks and complications, including allergic reactions, swelling, itching, abnormal healing, unsatisfactory results, and the possibility of unforeseen risks emerging over time. I understand that adhering to pre- and post-care instructions is vital for the success of my Exosome treatment and to minimise complications. I have read the information regarding Exosomes and understand the treatment risk and side effects. By submitting the Skin Patient Consent Form, you confirm and provide your consent to acknowledge and accept the risks associated with these treatments. You willingly agree to the terms mentioned above without any undue influence or coercion. Full Name: (required) Address: (required) Date: (required)