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Consent For EndyMed 3Deep
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Name
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First
Last
Email
*
Last 4 Digits Of IC Number
Are you sensitive or allergic to anaesthesia cream?
Yes
No
Patient Safety
I hereby declare that I have received detailed information regarding the use of the EndyMed system that uses radiofrequency (RF) energy for skin tightening
Treatment that uses RF energy for skin tightening results in deep heating of the skin in the treatment area. The treatment should not cause any pain, and usually has no side effects. Use of the system may cause temporary swelling and redness of the ski
In rare cases, a burn may occur at the treatment site. In this case, the treating therapist will immediately treat the area and will receive instructions on the course of treatment
I do not have implanted pacemakers ,arrhythmias or any other severe known heart disorder
I am not pregnant or lactating subjects
I do not have active or recent cancer of any kind
I am not using blood thinning medications, non-steroidal anti-inflammatory drugs (NSAIDS, e.g., ibuprofen containing agents) one week before and after treatment or any medication that would affect the characteristic of the skin (medical or hormonal), such as Isotretinoin (Accutane) within the past two months.
I do not have any history of diseases stimulated by heat, such as recurrent Herpes Simplex in the treatment area, may be treated only following a prophylactic regime.
I do not have any history of hip replacement, hip or femur surgery, or other metallic device in the treatment zone.
I do not have any form of suspicious lesion on the treatment area such as sores, psoriasis, eczema, and rash.
I hereby declare that I have read the above and understandthe implications andthat my consent is providedof my own free will. I have received a copy of thisconsent form, signed and dated
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About Us
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Acne / Lifting Treatments
NEOGEN™ Evo Plasma Treatment
EndyMed™ 3DEEP (Radio Frequency) RF
Exosome Facial
TAC Bojin Guasha Facial
Filgora Skin Booster (NCTF 135HA)
Plasma Fibroblast Skin Tightening
Skin Treatments
Hydrafacial™
Intraceuticals™ Oxygen Facial
EndyMed™ RF
Exosome Facial
NeoGen™ Evo Plasma Facial
Thesera L (Thread Lift)
Rejuran
Misty LED Facial Therapy
TAC 24K Gold Facial
TAC Signature Facial
Mesotherapy Facial
Body Treatments
New Doublo HIFU
Coolshaping2 Fat Freeze
EndyMed™ (RF)
Exosome Facial
QSculpting Pro (EM)
Needleless Thread Lift (Thesera)
CryoSnow SHR
Pink Intimate System (From Italy)
QuadPulse Pelvic Chair
Hair Treatments
Hydrafacial™ Keravive
GLASH Lash & Brow Regrowth
CryoSnow SHR
Gentle Gold Brow & Lip Wax
Japans No.1 Teeth Whitening
Japan Teeth Whitening (美白)
VISIA Skin Analysis
QuadPulse Pelvic Chair Therapy
First Trial Deals
Media
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