invisa-RED Consent/Waiver Form

Medical exclusions:

You are NOT eligible to receive invisaRED laser treatments if you have the following conditions: Pregnancy, medically implanted devices ie pace maker, epilepsy, severe hypertension, cardiovascular disease, renal disease, immune diseases, skin related auto-immune diseases ie. lupus, blood disorders/diseases, insulin dependent diabetes or have if you have had cancer/have not been cancer free for 6 months.

By signing below, I understand and accept all of the that visual documentation (photo and/or video) is necessary for evaluation and marketing. I hereby release and hold harmless this clinic and invisa-RED™ Technology from any reasonable expectation of privacy or confidentiality associated with the images and/or videos specified above. I further acknowledge that my participation is voluntary and that I will not receive financial compensation of any type.