I have completed the medical history form truthfully to the best of my knowledge, I understand that by declaring my medical condition that there are potential risks and I have been informed of the potential risks associated with combining my medical condition with laser treatments.

I understand that the decision to proceed with laser treatment despite having a medical reason not to do so is solely my own, and I release Pro Skin Clinic and its staff from any liability arising from such a decision.

I have been given the opportunity to ask questions and seek clarification regarding the risks and benefits of laser treatment, and I am proceeding with treatment voluntarily.

By signing below, I confirm that I have read and understand this disclaimer, and I consent to undergo laser treatment at Pro Skin Clinic.