Kybella consent form 2026

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Click ‘Get Form’ to open it in the editor.
Begin by reviewing the introduction section, which outlines what Kybella is and its purpose. This will help you understand the treatment you are consenting to.
Carefully read through the risks associated with Kybella injections. Ensure you understand potential side effects such as swelling, bruising, and nerve injury.
In the health history section, provide a full and truthful account of your medical conditions, especially those related to the neck area. This is crucial for your safety.
Sign and date the form at the bottom. Make sure both you and your healthcare provider sign where indicated to validate consent.

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Does insurance pay for Kybella?

Typically, insurance does not cover Kybella as it is considered a cosmetic procedure.

What makes you a candidate for Kybella?

If you eat well, exercise and are generally healthy but are consistently bothered by the appearance of a double chin, this could be the right choice for you. If you have tried everything to get rid of submental but still have a double chin, talk to your provider.

Do the Kardashians get Kybella?

The gorgeous Kardashian sister has already shared that she had help from CoolSculpting during her recent slim-down, and now, after Kim questioned her on Botox and Fillers, shes sharing how Kybella has helped her sculpt a leaner silhouette, while keeping all of her natural beauty intact.

How do you qualify for Kybella?

As a good rule of thumb, you can expect to qualify for Kybella injections if you are in relatively good health and worried about the appearance of your chin or neck. However, to qualify, it is important that you are not obese, pregnant, or breastfeeding.

Who is not a candidate for Kybella?

What Contraindications Are There for This Treatment? You will not be able to get this treatment if you are pregnant or breastfeeding. Additionally, you will be considered a poor removal candidate if you suffer from a bleeding disorder, like hemophilia.