CONSENT FOR ZELTIQ COOLMINI®
CoolMini® is a cryolipolytic process used in adults to treat visible fat and affect the appearance of lax tissue under the chin (submental area). CoolMini® procedure uses a non-invasive vacuum applicator to draw in tissue and deliver controlled cooling at the surface of the skin to target and kill fat cells. Then, the body eliminates dead cells over a period of weeks. This improves appearance by helping you lose unwanted fat in your face and neck. Desired results may take more than one treatment. The results are long-term but vary by individual. Submental fat bulges and laxity are cosmetic issues that some people choose to treat; they do not require treatment. There are also many other treatment options
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The safety and effectiveness for treatment of other areas and/or conditions has not been approved by the FDA. This type of use is called “off-label” and means that it has not been cleared by the FDA and that not all risks are known. While some off-label treatments may be reasonably safe, your skincare provider will use their judgement to determine if off-label use is appropriate for you to consider. Since there may be increased risks and complications with off-label use, only you can decide whether to proceed. By initialing this section, you confirm that all of your questions about off-label use have been answered and you give your informed consent for off-label use of CoolMini® as recommended by your skincare …show more content…
The procedure, as well as potential risks, benefits, have been fully explained. Common risks have been discussed, but not all potential risks are covered, and there may be other risks that are possible or unknown.
Any factor that impairs healing may increase the risk of complications or a poor outcome. Examples of important risks include smoking, diabetes, immunocompromised conditions (e.g. steroid use), and collagen vascular disease (e.g. lupus, scleroderma). I understand that I may be at increased risk of complications if I have any risk factor that impairs healing.
I understand that this procedure is purely elective. I can decide not to allow it at any time. I also understand that the results are not guaranteed, that outcomes are different with each individual, and that multiple treatments may be necessary. I also understand that I will be responsible for any future costs for treatments undertaken to improve, complete, or rectify the current
A physician cannot force a patient to undergo a procedure or treatment against his or her will. Physicians must make informed refusal an integral part of their informed consent process. Physician should understand what patients' needs and balance between the psychological need and social and physical health. Sometimes, the stress environment of the doctor made him frustrated and they don't spend enough time with their patient to get the optimum information and don't show interest about patients’ psychosocial problems. When a patient feel that their doctors have a lack of knowledge of other treatment options may also contribute to why patients refuse our treatment plan. Good physician-patient relationship allows a trusting relationship to develop. Most patients will agree to doctors’ treatment strategies if they have a good communication and patients are kept fully informed by their
A long-term risk is if patients have a negative experience, they won’t access care in the future. They may wait too long
Everyday, as I go through the morning ritual of applying my make-up, the visible signs of aging are becoming more apparent. I see skin that is starting to sag and everyday, I swear, a new wrinkle appears. Of the many things I can find fault with on my aging face, the most bothersome are the deep creases between my eyebrows. For this reason, five months ago, I decided to check out my options for obliterating these deep valleys on my forehead. After calling several cosmetic surgeons in the
This method is a way preferable alternative over routine medications and it can be utilized for managing irritation of muscles, influenza or frosty.
Risk factors for infection can be anything that suppresses the ability of the host to resist the infectious pathogen, including the following: drugs, such as steroids and chemotherapy; disorders that affect the innate and adaptive immune responses, such as cancer, leukopenia, and HIV/AIDS; and a breakdown of the first line of defense, such a trauma, broken skin, or surgical wounds. Patients are at risk for developing sepsis and septic shock if they are very old or very young and have and inability to fight off the infection. Some other risk factors for the
Therefore, one of the most important aspects of surgical asepsis is that the effectiveness depends on faithful and conscientious practice by those carrying them out. It is far better to err on the side of safety when using surgical asepsis than to take the slightest chance of possible contamination.
Several barriers may prevent the change. The hospital may be under budget and not able to buy equipment needed to perform the procedure properly. Some surgeons set in their ways may not be easily persuaded into
Treatments for cosmetic reasons also seem far fetched for me. However, make they make more sense than from my prior knowledge. People often believe that when working out in the heat the will burn more calories because they are sweating more, however, working out in the cold the body actually has to work harder to regulate the temperatures. Then in theory cool treatments cold make sense depending on the amount of time a person is in the chamber for. For acne I have also often used ice to close my pores as it tightens skin which supports they could use to support their claims in all the advertisements I hear on the radio that cool treatments can tighten skin, yet it still seems far fetched to
The issues that are prone to high risks can be surveyed by this process as a detailed survey would help overcome many hazards which can threaten the safety of patients. Examples of these issues would be disinfection, diagnostic imaging, cleaning, sterilization etc (Joint, 2007).
This declaration and the following directions are an expression of my legal right to refuse medical care and treatment. I expect and trust the above-mentioned parties to regard them as legally and morally bound to act in accordance with my wishes, desires, and preferences. The above-mentioned parties should therefore be free from any legal liabilities for having followed this declaration and the directions that it contains.
If they can not do the surgery then there are other treatment that they can do.
discuss in detail the consequences and likelihood of risks occurring. Tiger teams were established to find
1. These health risks may be minor or major, and may even lead to death.
Explain the reason why the task needs to be done, its importance, and possible complications that can occur.
operations just to be assured that the health risks stay as minimal as possible. However,