• Prp Consent Form

  • Platelet-rich plasma (prp) therapy is a form of regenerative medicine that can harness these abilities and strengthen the natural growth factors your body uses to heal tissue.

  • Client Details

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  • The purpose of this consent form is to make you aware of the nature of the procedure and its risks so that you may decide if you would like to move forward with the treatment.

  • Procedure

  • Pre-treatment – for the best results it is recommended to avoid any anti-inflammatory medications for 2 weeks prior to the
    procedure. This allows for increased platelet function and growth factor release.
    1. Approximately 30cc of blood is drawn from the patient.
    2. The tube(s) are then placed into a centrifuge where the blood is spun in order to separate the PRP from the red blood cells.
    3. The PRP is then drawn up into syringes.
    4. The PRP is then either injected into the skin by a Physician.
    5. When the PRP is injected just beneath the skin it is common to see unevenness in the treated area for up to a week.

    Post-treatment – Avoid anti-inflammatory drugs for 1-4 weeks for best results. Light exercise and normal daily activities are allowed.

    Risks/Discomfort

    • Tenderness, bleeding, bruising and infection
    • Redness of the skin
    • Swelling
    • Asymetry
    • Allergic Response

    Contraindications

    • Pregnant
    • Anti- Coagulation Threapy
    • Acute and chronic infections
    • Chronic liver disease 

  • Consent

  • The benefits and risks of the procedure, including alternative treatments, were explained to me, and I was given the opportunity to ask questions, and I received answers to my questions. I have read this confirmation and confirm that I understand its contents. I have enough knowledge to consider the disclosure and feel that I understand enough to allow it. I also agree to comply with all pre- and post-treatment care instructions as specified, I give my consent.

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