I am authorizing cosmetic procedure(s) to be performed. I have been aware of the nature, goals and limitations and possible complications of the procedure(s).

I clearly understand and accept the following:

1. The goal of any procedure is improvement, not perfection. I understand result can vary dependent on several factors including skin color, donor area, hair color, the materials been used and the reaction of each person to the procedure.
2. There may be more treatment necessary than I anticipated.
3. The fees have been discussed with me and I understand them. The fee at the time of services is for the procedure only unless package time is purchased.
4. The fees and payments have been discussed with me, and I understand. The full payment should be cleared before starting the surgery.

• For same-day cancellations of surgery appointments, a 50% charge of the total amount will apply, while 20% charge will be incurred for cancellations made before three days, including reasons related to blood test reports.

5. Potential risk and complication:

• Smoking has negative affect on the result of transplant and delay or interfere with the growth of transplanted hair by causing necrosis of skin and oxidative stress.
• Numbness: It is common for some portion of the top-rear of the scalp to be partly numb for a few days after surgery. It gradually returns to normal during the next few months.

However, side effects may occur and although complications are infrequent, I understand the following side effects or complications may occur and are theoretically possible:

1. Discomfort at the treatment area for a short period.
2. Edema (Swelling), erythema (redness), or bruising. The treated area may feel tender for a few hours after treatment and could last 5 to 10 days.
3. Decrease or increase in pigmentation may occur for a short period of time.
4. Loss of pigmented lesions such as freckles may occur.
5. Activation of cold sores if being treated head scalp (antiviral medication is recommended and is available by prescription or over the counter)
6. Folliculitis (inflammation in the hair follicle), this is related to laser removal, hair transplant and it last for few weeks to months then it will disappear.
7. (Vein-leg or face) bruising can last up to six weeks after treatment for some skin types.
8. Results for Botox injection cannot be judged before 2 weeks from the day of injection.
9. Some cases of filler injection might need touch-up sessions after one week.
10. I authorized the use of any photographs to be taken for comparing results and will be confidential.
11. With hair transplant Hair follicle removed from donor area will not grow from same spot as it’s transferred to baldness area.

I received all the post procedure instructions, and I will follow the rules.