I understand that certain procedure(s) elected are relatively new and little is known about their long-term safety and effectiveness. I understand that each person has a different response to Body Contouring.

I understand that the procedure(s) do not correct health problems, including but NOT limited to diabetes, heart attack, stroke, high cholesterol, blood clots, lung problems, stomach, intestinal problems, bladder disease, an abnormality of the skin Good Vibez Beauty is not a medical facility and does NOT make medical decisions. You must consult with your Primary Care Physician for medical advice.

I understand that I may need post procedure care. I will dutifully be responsible and compliant with the recommendations from my Good Vibez Beauty Clinician, which may include, but are not limited to skin care products, garments, diet, etc.

I understand that procedures involve risk. Risk may include, but not limited to redness, swelling, irritation, burns, skin reactions, etc. I must immediately report any unusual symptoms known to me to my Good Vibez Beauty Clinician that includes, but NOT limited to being aware of any slight nature or prominence of persistent chills, fever, redness, increased warmth, excessive bruising or swelling, etc. at the sights treated and systematically.

I give Good Vibez Beauty permission to use data about my treatment for research purposes. I understand that my name and personal identifying information will remain confidential unless I have written permission to disclose this information. I give Good Vibez Beauty professional permission to photograph/video my procedure(s).

ALTERNATIVE TREATMENTS

It has been explained that other temporary and more permanent treatments are available to sculpt, contour, tone, exfoliate, clean and detoxify the body. Alternative forms of management include receiving NO treatment at all. If treatment is chosen alternative body sculpting therapies and other services offered include the following: Lipo Laser, Cryoliposis. Ultrasound Cavitation, Vacuum Therapy, Electrotherapy, Vibration, Cold/Hot Wraps, Infrared Rays, Reduction Massage, Lymphatic Drainage, HIFU Vaginal Tightening, Teeth Whitening, Topical Skin Therapies i.e. gels, creams, oils, facials etc. Surgical options include Liposuction, Tummy Tucks, Fat Transfer, Muscle Repair etc. I understand that risk and potential complications are associated with these and alternative forms of non-surgical and surgical treatments.

CANCELLATION POLICY

If there is a need to cancel for any reason we ask for a 24-hour notice. “NO SHOW” for appointments made outside of normal business hours WILL result in a $50 service charge deductible from prepaid service package. Remaining balance will be applied towards next service appointment with regards to TIME LIMITS FOR SERVICE AGREEMENT.

Initial - Cancellation Policy

TIME LIMITS FOR SERVICE

Specials, Flash Sales & Promotional Priced Services MUST BE completed within 30 days of purchase date. Regular Price Services MUST BE completed within 60 days of purchase date.

Initial - Time Limits for Service Policy

RELEASE OF LIABILITY

I herein certify that I am not pregnant or nursing. I understand that NO GUARANTEES OR WARRANTIES have been made to me regarding the outcome or any improvements to my condition due to the procedure(s) I have elected to undergo. I am paying for a service and not desired results from treatments. I have been given the opportunity to ask questions and have received satisfactory answers to those questions by the treating staff representative.

I consent to the taking of photographs/video for documentation during my treatment(s) unless otherwise stated with written notice to Good Vibez Beauty. These photos may be used for marketing and/or publication for the further benefit of educating the public. All attempts will be made to protect my identity.

I agree to indemnify, hold harmless and release Good Vibez Beauty, its employees, members, representatives, affiliated organizations, and others acting on the Company's behalf of all claims, demands, causes of action and legal liability, whether the same be known or unknown, anticipated or unanticipated. I further agree that in except in the events of the Company's gross negligence or willful misconduct, no claims, demands, legal actions and causes of action shall be made against the Company for any economic and non-economic losses of any kind.

I am aware that there is a worldwide pandemic circulating called COVID-19. I am aware that Good Vibez Beauty has been trained in Infectious Disease Control and is taking all necessary precautions to insure my safety in this environment. However, body contouring is an elective service and I am participating in such services at my own risk. I will not hold Good Vibez Beauty responsible if I test positive for COVID-19.

Finally, I certify that I have read and fully understand the contents of this form and that the disclosures referred to the above were made prior to my signing the form below.

Initial - Release of Liability

NO REFUNDS OR RETURNS — ALL SALES ARE FINAL

I ACKNOWLEDGE THAT I HAVE HAD A FAIR OPPORTUNITY TO ASK QUESTIONS ABOUT GOOD VIBEZ BEAUTY PROCEDURES FOR BODY CONTOURING AND THE ALTERNATIVE TREATMENTS AVAILABLE. I ALSO ACKNOWLEDGE THAT MY QUESTIONS HAVE BEEN ANSWERED TO MY SATISFACTION. I UNDERSTAND AND ACCEPT THE POTENTIAL RISKS AND COMPLICATIONS INVOLVED.

By submitting this form, I provide my informed consent for non-surgical body contouring, skin therapies, vaginal tightening, and teeth whitening.

Shape and Sculpt Consultation

part 2

Informed Consent for Non-Surgical Body Contouring/Skin Therapies/Vaginal Tightening/Teeth Whitening

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