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ACKNOWLEDGMENT OF SERVICES I understand that Nitengale Dollz provides non-surgical, non-invasive aesthetic and wellness services, which may include but are not limited to: ACKNOWLEDGMENT OF SERVICES I understand that Nitengale Dollz provides non-surgical, non-invasive aesthetic and wellness services, which may include but are not limited to: Medical weight management programs Body refinement therapy injections Post-operative lymphatic drainage and recovery care Skin rejuvenation treatments (including PRP, RF therapy, BB Glow, etc.) Body contouring and wellness therapies

* * I acknowledge that all services are elective and are not intended to diagnose, treat, cure, or prevent any medical condition.

UNDERSTANDING OF RISKS: I understand that while all procedures are performed with care and professionalism, no guarantees or assurances have been made regarding results. Possible side effects may include but are not limited to: UNDERSTANDING OF RISKS: I understand that while all procedures are performed with care and professionalism, no guarantees or assurances have been made regarding results. Possible side effects may include but are not limited to: Swelling Bruising Redness Temporary discomfort

* * I accept that individual results vary and depend on multiple factors beyond the provider’s control.

POST-TREATMENT RESPONSIBILITY POST-TREATMENT RESPONSIBILITY I agree to follow all post-treatment care instructions provided by Nitengale Dollz. I understand that failure to follow instructions may affect results and increase the risk of complications.

NO MEDICAL ADVICE DISCLAIMER NO MEDICAL ADVICE DISCLAIMER I acknowledge that services provided at Nitengale Dollz do not replace care from a licensed physician or primary care provider. I understand that I am responsible for seeking medical attention if symptoms or concerns arise outside the scope of aesthetic care.

RELEASE OF LIABILITY RELEASE OF LIABILITY I hereby voluntarily release, waive, and discharge Nitengale Dollz, its owner, staff, contractors, and affiliates from any and all liability, claims, demands, actions, or causes of action arising out of or related to my participation in services, except in cases of gross negligence.

PHOTOGRAPHY & MEDIA CONSENT (OPTIONAL) PHOTOGRAPHY & MEDIA CONSENT (OPTIONAL) I DO consent to before-and-after photographs for documentation and educational/marketing purposes. I DO NOT consent to photography or media use.

Initials

FINANCIAL & REFUND POLICY FINANCIAL & REFUND POLICY I understand that all services are non-refundable, including deposits, packages, and completed or partially completed treatments.

ACKNOWLEDGMENT & SIGNATURE: I confirm that: ACKNOWLEDGMENT & SIGNATURE: I confirm that: I have read and understand this document in its entirety I have had the opportunity to ask questions I voluntarily consent to treatment

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