By checking, I hereby give consent to the physicians and staff of The Advanced Laser and Cosmetic Center to discuss, examine, photograph, and keep a confidential record of my evaluation and care. I consent to any treatments that I request by any physician and/or qualified staff during my treatments and care at the Center. I understand that brochures, written material, verbal statements, videos, photographs, or other types of media are for the purpose of illustration, discussion and education only. I understand that the practice of medicine is not an exact science and I now stated my understanding that no gaurantees or warranties have been or will be made or implied as to my own final appearance or results. I have read and agree to the terms of the financial poicy on the reverse side of this page. The above medical history is true and I will inform the Center if any changes occur prior to future treatments.
