Please answer the following question with full honesty and accuracy.
Please read all the sentences and sign the agreement.
I understand the possible side effects of the procedure and will be able to diagnose if it is normal or not.
I confirm that I do not have any physical, medical, and mental conditions that might get conflict with the procedure.
I confirm that I will strictly follow the pre and post-procedure instructions given to me.
I confirm that all information I entered in this form is accurate and true to the best of my knowledge.
I hereby certify and give this clinic my full consent to perform the necessary procedure. By signing below, I confirm that I have read and understood the statements above.