Waiver of Physician Consultation


    I understand and acknowledge that there are risks associated with participating in
    Bodika cosmetic Med Spa treatments without obtaining seeing our physician on face to face
    consultation.

    I understand that it is generally recommended that all adults consult with a physician
    before starting Bodika cosmetic Med Spa treatments.

    I further understand that based on my health history information noted on the Bodika cosmetic Med Spa Medical History Form.

    Bodika cosmetic Med Spa staff has recommended that I consult with and obtain
    recommendation from a physician before any treatment starts.

    I acknowledge that I choose not to follow the recommendation for physician approval
    and consultation. I assume full and entire responsibility for all of the treatment results at
    Bodika cosmetic Med Spa.

    I have read and agreed to Terms and Conditions


    What's your name?



    Participant Signature




    What's your name? (optional)



    Parent/Guardian Signature if under 18




    What's your name? (optional)



    Witness Signature