Anti Viral IV

The virtual consultation must be followed by a final visit to a Lightsculpt Doctor/Therapist at the appropriate time to finalise and confirm you treatment. The virtual consultation can only be used a guide to your specific skin requirements and in no way can be construed as a guaranteed recommendation. The virtual consultation process is a private forum between Doctor/Therapist and you, your information and all information discussed is confidential. Lightsculpt, its Doctors and staff are not held liable for all and any matters arising from a virtual consultation with you. I herewith agree to the following: I certify that I am a competent adult of at least the age of eighteen and this is my free and voluntary decision that is executed; I have answered all the questions contained herein with accuracy, honesty and to the best of my ability. If there are changes to my medical history, operations or medications I will be responsible for informing the centre of the updates and any other serious conditions that may be relevant; I agree to adhere to all safety precautions and regulations during the treatments and to follow all aftercare instructions. The centre does not take responsibility for therapy’s done at other practitioners or centres that may cause side effects to the treatment(s); and My digital submission of this form indicates my informed consent to the treatment(s) and my acceptance of the conditions outlined herein. I hereby authorise Lightsculpt to compile, collect and retain at the premises of Lightsculpt (or any branch thereof) all of my personal health information relating in any way to any treatment or procedure of any kind which I undergo at the premises of Lightsculpt and I hereby instruct Lightsculpt not to release such information or any copy thereof to any person without my specific consent. I specifically authorise Lightsculpt to make such personal health information available only to my elected Doctor referred to above and then only at the premises of Lightsculpt and I hereby specifically terminate any doctor patient relationship with any other Doctor (other than my elected Doctor referred to above) who I may have previously consulted at the premises of Lightsculpt. I absolve Lightsculpt of any liability for damage to such property through any means whatsoever. I specifically authorise Lightsculpt to copy my personal health information for Lightsculpt’s record purposes as it, at its sole discretion, deems necessary. I hereby instruct Lightsculpt not to release my personal health information or any copy thereof to any person without my specific consent. I specifically authorise Lightsculpt to make such personal health information available only to my elected Doctor referred to above and then only at the premises of Lightsculpt and I hereby specifically terminate any doctor patient relationship with any other Doctor (other than my elected Doctor referred to above) who I may have previously consulted at the premises of Lightsculpt. I have read and understood the treatment information guide relating to my treatments at Lightsculpt. I have been advised that all treatments may differ due to variables such as age, lifestyle etc. Lightsculpt Aesthetic Clinic may contact me regarding new services and/or goods that may be on offer, including promotional offers? I acknowledge that Lightsculpt has a strict no refund policy. If I am to develop a medical condition during my course of treatment, which excludes me from my treatment, Lightsculpt will not be held liable for refund.