I, _________________________________________ authorize and consent to the treatment for the removal of superficial wrinkles and/or pigmented lesions with the Phoenix-15 CO2 Laser.
I have been advised of the purported advantages and disadvantages associated with this treatment
I understand that treatment with this laser system varies from patient to patient and that that more that 1-treatment may be required.
I hereby indemnify and hold harmless Rohreer Aesthetics, LLC, the treating technician and New Skin and Body Aesthetics from any and all liability, damages, cost, and expenses arising from or out of the use Phoenix-15 CO2 Laster for treatment of wrinkles and/or the removal of pigmented lesions. blank