Introduction:  Thank you for considering our allograft blood products derived from placental tissue for therapeutic and aesthetic purposes.  Please review this legal disclaimer and consent. 

Product Description:  Our products contain blood cells that promote healing and regeneration by reducing inflammation and stimulating the body's natural processes. 

Contraindications:   Treatment is contraindicated if you are pregnant, breastfeeding, under 18, have active inflammation/irritation, chronic blood-borne diseases, prone to excessive bruising/poor healing, or contraindications to micro-needling/laser resurfacing. 

Risks:  Potential temporary side effects include injection discomfort, swelling, bruising, itching, tenderness, lumps/bumps, asymmetry, or infection.   Discuss risks with your provider.

Consent:

·       I consent to clinical photography for medical, educational, and scientific purposes.

·       I understand results are not guaranteed and additional treatments may be needed.

·       I have disclosed my complete medical history and will update the provider on any changes.

·       I understand the risk and consent to allograft blood products and extracellular matrix treatment.

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Legal Disclaimer:

·       These products do not constitute stem cell therapy and do not cure any condition.

·       They have not been evaluated or approved by the FDA for medical use.

·       Participation in any experimental protocols is voluntary.

By signing below, I acknowledge reviewing and consenting to the above terms.