demo COnsents

Informed Consents for Demonstration Treatment

In consideration of the opportunity afforded to me to participate in an event (the “Event”) sponsored by Vibrant Med Spa, Inc. (the “Company”), I hereby agree as follows:

I understand that I’m receiving this treatment for demonstration purposes only, and that I will not receive an entire series of treatments. I understand that completing a full treatment series is necessary to maximize treatment effectiveness.

I understand that the treatment may involve risks of complications or injury from both known and unknown causes, and I freely assume these risks. I confirm that I do not have any of the following contraindications:

• Pregnancy and/or breastfeeding
• Metal or electronic implant in the treatment area
• Cardiac pacemaker and/or implanted defibrillator
• Implanted neurostimulators
• Drug pump(s)
• Malignant tumor
• Hemorrhagic condition(s)
• Epilepsy
• Recent surgical procedure(s)

I authorize the Company to use my name, voice, likeness and images (collectively, the “Assets”) in any and all lawful channels, including but not limited to social media, websites, printed or electronic materials, news media, closed circuit television, or advertisements. The Assets may be used for any and all lawful purposes, including but not limited general advertising. I hereby waive all rights to inspect and approve the finished product, its use or such copy as may be used in connection therewith.

I certify that I have read this entire document and that I agree with all provisions. I certify that I have had the opportunity to ask questions and these questions have been answered in full to my satisfaction. I fully understand the treatment conditions, the procedure and possible side effects.

Review of facts about light therapy

Hair reduction requires more than one treatment and does not remove all hair. Generally hair reduction is decreased in the amount of hair growth by 60-90% on average. Results depend on color and location of hair follicles. A general range of 4-12 treatments spaced 4-8 weeks apart is possible for maximum results.

Light from a laser can be harmful to eyes and wearing special safety eyewear is necessary at all times during the procedures.

Light from BBL is an intense burst of light and even though the special safety eyewear is in place, you will sense light emanating from the treatment area.

The sensation of light may be uncomfortable in certain areas and feel like pin pricks or bursts of heat. The use of topical anesthetics is at the discretion of the practitioner as there are known severe allergic reactions to ingredients in topical anesthetics.

I have read and understand the section above.

Common side effects and risks

Erythema (redness) may occur in the area of treatment. This may last several hours. Edema (swelling) around the hair follicles is called peri-follicular edema and is a sign that the hair follicle has been affected. Urticaria (itching) or hive-like appearance is also associated with the thermal light affecting the surrounding skin. These symptoms usually subside in a few hours. A cool compress placed on the area provides comfort. The treated area should be cared for delicately for at least 12 hours. Limited activity may be advised, as well as no hot tub, steam, sauna, or shower use.

A blister can form up to 48 hours after treatment. An antibiotic cream or ointment can be used. Other short term effects include bruising, superficial crusting, and discomfort.

Hyperpigmentation (browning) and hypopigmentation (lightening) have been noted. These conditions usually resolve within 2-6 months. Permanent color change is a rare risk. Vigilant care must be taken to avoid sun exposure (tanning beds included) before and after the treatments to reduce the risk of color change. Sunscreen and / or sun block should be applied when sun exposure is necessary.

Infection is not usual after treatment; however herpes simplex virus infections around the mouth can occur following treatments. This applies to both individuals with a past history of the virus or individuals with no known history. Should any kind of infection occur, your clinician must be notified to prescribe appropriate medical care.

Allergic reactions resulting from treatment are uncommon. Some persons may have a hive-like appearance in the treated area as discussed above. Some persons have localized reactions to cosmetics or topical preparations. Systemic reactions are rare.

I have read and understand the section above.

Alternative methods of hair reduction are: shaving, waxing, electrolysis, chemical epilation, and threading. I choose to try hair reduction therapy by laser and/or BBL light therapy.

I certify that I have read this entire document and that I agree with all provisions. I certify that I have had the opportunity to ask questions and these questions have been answered in full to my satisfaction. I fully understand the treatment conditions, the procedure and possible side effects.

I understand that compliance with pre and post care instructions is crucial for success of hair reduction therapy and to prevent unnecessary side effects or complications.

I understand that the hair reduction therapy involves payment and the fee structure has been explained to me.

I hereby give my consent and authorization, and release the Company, the Administrator of the treatment and their respective owners, agents, representatives, officers, shareholders, employees, partners, directors, attorneys, subscribers, successors and assigns of any claims that I have in the future in connection with the described treatment.