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I duly authorize Canvas Aesthetics (Pty) Ltd to perform the Elase treatment

I understand that Elase is an approved technology consisting of radio frequency and laser light (elos) and is used for long term hair reduction of which I hereby consent to be a client receiving the Elase treatment on the specified area above.

I understand that clinical results may vary depending on individual factors, including medical history, skin type, client compliance with pre/post treatment instructions and individual response to treatments.  

I confirm that I have informed the staff regarding any current or past medical condition, disease or medication taken and that the list of contraindications has been fully explained to me. I also undertake to inform the staff of any changes to my medical condition or medication taken during the course of my treatment or any further future treatments.

I understand that there is a possibility of temporary Short-Term Effects which have been fully explained to me:

  • Erythema (redness of the skin)
  • Oedema (slight swelling due to the heat)
  • Mild burning (with or without a blister)
  • Temporary discoloration of the skin (if burnt)
  • Scarring and permanent discoloration if a blister was scratched or popped
  • Temporary bruising or formation of small red / purple spots caused by pressure

I have been fully informed and understand:

  • The treatment involves a series of sessions which need to be continued at set intervals per the clinical trials (facial: once every 4 - 6 weeks and body: once every 6 - 8 weeks) – failure to adhere will result in a less desired outcome
  • The nature and purpose of the treatments
  • Expected outcomes and possible short-term effects
  • The final result obtained cannot be guaranteed – over several treatment sessions there will be less hair growth which a gradual and cumulative reduction is. When hair does grow back between treatments, it will be less, finer, lighter and slower growing.
  • The fee structure including the payment terms and conditions
  • The late arrival, no-show and cancellation policies
  • My condition is of cosmetic concern and that the decision to proceed is based solely on my expressed desire to do so.

I confirm and understand that the Pre-Treatment Protocols have been fully explained to me and are important and advisable for the desired outcome and that I undertake to / have adhered to these requirements prior to my treatment.

I confirm and understand that the Post-Treatment Protocols have been fully explained to me and I will adhere to these requirements after my treatment. I also acknowledge and understand that Maintenance and additional Home Care Routines are advisable for effective and long-lasting results.  

I understand the importance of Before and After Photographs and consent to the following: 

  • The taking of my before and after photographs
  • Authorize their anonymous use for the purposes of medical audit, education and promotion.

I have read and fully understand the contents of this consent form.

Do you agree to the above terms and conditions?
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