I am of sound mind, aware of all risks and possible complications.

This procedure is voluntary, and no guarantees regarding results have been made.

I have read all provided materials, and my questions and concerns have been addressed.

I will attend post-procedure check-ups and follow all post-treatment instructions.

I consent to necessary anesthetics, understanding associated risks.

Unforeseen conditions may require additional procedures, which I authorize.

I release The Loft, the Medical Director(s), and the provider from liability related to this procedure.

I understand and consent to the administration of Botulinum A Toxin injections as discussed with my provider.

Botulinum A Toxin injections temporarily weaken targeted muscles for approximately 3-4 months to reduce wrinkles.

FDA-approved for glabellar frown lines and crow’s feet; used off-label for other areas based on desired effects.

Common: Pain, bruising, redness, swelling, tenderness, headache.

Rare but possible: Muscle weakness, drooping eyelids/eyebrows, dry eyes, vision changes, difficulty swallowing, speaking, or breathing.

Extremely rare: Severe allergic reactions, distant spread of toxin effects, respiratory issues, or death.Business Operations: We may share your information with third-party service providers who assist us in performing essential business functions, such as payment processing, customer support, and website maintenance.

Compliance with Legal Requirements: We may disclose your information when required by law or to comply with legal processes.

I acknowledge the possibility of treatment ineffectiveness due to antibody development.

I consent to photos/videos for medical records.

I have been fully informed about the procedure, its benefits, limitations, and alternatives.

I accept all risks and possible complications associated with Botulinum A Toxin treatments.