Lotus @ QUEENSWAY MEDICAL
A Physician-Led Clinic

Specific Informed Consent for MORPHEUS8 Treatments
This form is designed to give you the information you require to make an informed choice of whether or not to undergo treatment with Forma Plus technology.
If you have any questions before your treatment please feel free to ask.
• I hereby authorize Dr. Bedaj and/or such assistants as may be selected to perform the Forma Plus procedure.
• The physician obtained my medical history and found me eligible for treatment.
• I have received the following information about the technology:
  - FORMA/PLUS is a non-invasive technology that utilizes radiofrequency (RF) and is indicated for facial/neck (FORMA) or body areas (PLUS) skin tightening.
-  The FORMA/PLUS treatment induces heating of the dermal and sub-dermal layers which stimulates a reaction leading to collagen generation and replenishment.
-   The treatment creates a warm sensation over the skin surface.
-   I understand that taking the treatment course is my choice and that I am free to withdraw at any time, without giving
any reason.
•    There may be alternative procedures or methods of treatment that causes skin tightening by heating the tissue, such as lasers, 1PL, and RF technologies, but none of them involves skin temperature control for safety, like FORMA/PLUS. Details were explained to me.
I was told about the possible side effects of the treatment including local pain, skin redness (erythema), swelling
(edema), damage to the natural skin texture (crust, blister, burn), change of pigmentation (hyper- or hypo-pigmentation), and scarring. Although these effects are rare and expected to be temporary, any adverse reaction should be reported immediately.

I understand that taking the treatment course is my choice and that I am free to withdraw at any time, without giving any reason.
•    There may be alternative procedures or methods of treatment that causes skin tightening by heating the tissue, such as lasers, 1PL, and RF technologies, but none of them involves skin temperature control for safety, like FORMA/PLUS. Details were explained to me.
I was told about the possible side effects of the treatment including local pain, skin redness (erythema), swelling
(edema), damage to the natural skin texture (crust, blister, burn), change of pigmentation (hyper- or hypo-pigmentation), and scarring. Although these effects are rare and expected to be temporary, any adverse reaction should be reported immediately.
I understand that the treatment involves about 8 weekly sessions, and that maintenance sessions may be required periodically, once in a few months, according to individual responses.
I understand that I have to comply with the treatment schedule, otherwise, results may be compromised.
•    I recognize that during the course of the procedure, unforeseen conditions may necessitate different procedures than this above and I authorize the physician or assistants to perform such other procedures if they find them professionally desired.
•    I understand that not everyone is a candidate for this treatment and results may vary. Therefore, there is no guarantee as to the results that may be obtained.