Photography and
Social Media Release Xthetics Face & Body Sculpt

I consent to be photographed during the course of my treatment with Xthetics Face & Body Sculpt, I understand that the purpose of such photographs is to track the progress of my treatment(s). I understand that my photographs are part of my medical records and therefore, are the property of Xthetics Face & Body Sculpt.

I consent to the use of my photographs, at the discretion of Xthetics Face & Body Sculpt, for marketing, research, educational, or scientific purposes. I understand that every attempt will be made to protect my identity and my name will not be disclosed.

I do not consent to Xthetics Face & Body Sculpt to share my result pictures on social media, for marketing, research, educational, or scientific purposes.

Disclaimer

I understand that all medical cosmetic treatments are provided exclusively by Xthetics Face & Body Sculpt. I will not hold Xthetics Face & Body Sculpt, its owners or its employees/contractors, responsible for the results I experience. I realize that results may vary. I further understand that Xthetics Face & Body Sculpt cannot prescribe an exact number of treatments to satisfy each individual's opinion and that the number of treatments I complete will be at my own discretion.

I understand that even with the best technology, best products, and the highest trained and board-certified medical providers, there are a percent of patients that are non-responders and will not have a desired response/outcome to treatments.

I have read and fully understand all the terms of this Acknowledgement of Practice Policies form, all my questions have been answered to my satisfaction and I, the undersigned, agree to the terms of this consent.