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Click ‘Get Form’ to open the Consent To Cosmetic Mesotherapy Treatment document in our editor.
Begin by entering your name in the designated field at the top of the form. This personalizes your consent and ensures clarity.
Next, circle all applicable body areas where you wish to receive treatment. Options include 'Love Handles', Abdomen, Thighs, and more. Make sure to select all that apply.
Review each section carefully, especially those detailing potential risks and benefits. Initial next to each statement to confirm your understanding and agreement.
In the final section, print your name, sign, and date the form. This confirms that you have read and understood all information provided.

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Can anyone do mesotherapy?

You will be invited for a consultation to assess your suitability for Mesotherapy treatment. Usually anyone is suitable for treatment but during your consultation we will ensure you have no allergies to the treatment cocktail and whether or not you are pregnant.

Is mesotherapy legal in the US?

Mesotherapy as a procedure hasnt been approved by the U.S. Food and Drug Administration (FDA), but many of the ingredients used in the treatment do have FDA approval for treating other conditions. As long as the ingredients have FDA approval, they may be used for mesotherapy.

Can estheticians do mesotherapy?

Unlicensed medical assistants, licensed vocational nurses, cosmetologists, electrologists, or estheticians may not legally perform these treatments under any circumstances, nor may registered nurses or physician assistants, without supervision of a physician.

Who cannot have mesotherapy?

Who cannot have mesotherapy? Pregnant women, people who had a stroke, diabetes patients, heart disease patients on multiple medications, cancer patients and people with blood clotting problems cannot have mesotherapy.

Is mesotherapy cosmetic surgery?

Mesotherapy is a nonsurgical, permanent method for removal, body contouring and is also used for hair loss and skin ageing. It was first developed in France in 1952 to treat vascular and lymphatic disorders.