Skin Tag Removal Consent Form

I understand that I will receive a Cosmetic Skin Tag Removal. In this regard, by signing this form I understand and declare the following:

1. The risks of the treatment have been explained to me. I understand that this is purely a cosmetic procedure and I have been cleared by my physician concerning this procedure. 

2. There are risks involved in the treatment such as blood loss, scarring, infection, and thickening of the skin. Should these occur, I might need to take some antibiotics as prescribed by my physician. 

3. Post care procedures are necessary and requires my cooperation. I will follow the instructions given to me and make sure to keep with the appointments for check-ups in order to observe the progress of the treatment made.

4.There is no guarantee of results of any treatment.

5. It is my responsibility to ensure that treatment is covered by my insurance. Otherwise it is my responsibility to pay for the treatment.

By signing this form, I acknowledge the information above. I have had the opportunity to ask questions and all of which were answered to me completely to my satisfaction. Alternative methods of treatment has been explained to me and I understand that I have the right to refuse the methods of treatments.

I hereby release the skin clinic, its staff, technicians, and/or estheticians from any liability or damages which I may incur during or after treatment by which is associated with this procedure which I am to undertake.

Finally, I hereby certify that I am of legal age with full legal capacity to execute this consent. I am freely, expressly, and voluntarily executing this consent.