I hereby acknowledge that I have requested & voluntarily consent to a hyaluronidase treatment from MedSpa at Villagio.

I understand that no guarantee can be made as to the result of treatment & that hyaluronidase use for filler corrections is an off-label non-approved use.

I confirm that in order to undergo said treatment, I accept the following preconditions.

 I understand that MedSpa at Villagio and associated medical providers recommends no treatment, and prefers the material to break down over 6 – 12 months.

MedSpa at Villagio and medical staff cannot be responsible for any results of treatment from any other physician or service provider.

I will not hold MedSpa at Villagio or medical staff legally or financially responsible for anything resulting from the treatment that I deem unsatisfactory.

I acknowledge and accept that I have been fully informed that results are not guaranteed and vary from person to person.

I acknowledge that the procedure has been explained in detail during a consultation, and has made me fully aware of all the possible outcomes and/or side effects (bruising, swelling, and pain, possibility of lumpiness or irregularity in the contour of the treated area and/or textural changes to the skin that may last for weeks).

I understand and accept the above and enter into this agreement willingly and voluntarily. I understand that any treatment provided may or may not meet my expectations.

I understand and agree that there is no compensation or refund of monies paid in any event.

I consent to the taking of photographs and authorize their anonymous use for the purposes of medical audit, education and promotion.