CoolSculpting Consent Form

  • WHAT YOU CAN EXPECT:
  • DO YOU HAVE ANY OF THE FOLLOWING?
  • As with most medical procedures, there are risks and side effects. These have been explained to me in detail. I have read the above information, and I give my consent to be treated with CoolSculpting® by Dr. Lisa Gardner and her designated staff.
  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY