Forma

What is Forma?

Forma is a non-surgical skin tightening treatment that uses radiofrequency technology to stimulate collagen production and improve skin elasticity.

How does Forma work?

Forma delivers controlled radiofrequency energy to the skin, heating the targeted tissues and stimulating collagen production. This results in firmer, tighter skin over time.

What areas can be treated with Forma?

Forma is commonly used to treat areas of the face and neck where skin laxity is a concern. It can be effective for reducing fine lines and wrinkles.

Is Forma painful?

Forma treatments are generally well-tolerated. Most patients experience a warm sensation during the procedure, but discomfort is minimal. A topical anesthetic may be applied to enhance comfort.

How long does a Forma treatment session take?

The duration of a Forma session depends on the areas being treated but typically ranges from 30 minutes to an hour.

How many Forma treatments are needed to see results?

The number of sessions needed varies based on individual factors and the desired results. Typically, a series of treatments spaced a few weeks apart is recommended.

When will I see results from Forma?

Patients may notice some immediate tightening after the first session, but optimal results usually develop gradually over several weeks as collagen production is stimulated.

Is there any downtime after Forma treatments?

There is typically no downtime after Forma treatments. Patients can resume their normal activities immediately after the procedure.

Are there any side effects associated with Forma?

Common side effects include mild redness and swelling, which usually subside shortly after the treatment. Serious side effects are rare.

Who is a good candidate for Forma?

Forma is suitable for individuals with mild to moderate skin laxity who want a non-surgical solution for skin tightening and collagen stimulation.

Can Forma be combined with other cosmetic procedures?

Yes, Forma can be used in combination with other treatments, such as dermal fillers or laser therapy, to achieve a more comprehensive facial rejuvenation.

How long do the results of Forma last?

The longevity of results varies, but with proper maintenance treatments, the effects of Forma can be extended. It is recommended to discuss a personalized treatment plan with a healthcare professional.

Crawford Contour

$250 / $200 CC

Full Face with Neck

$400 / $350 CC

Full Face

$300 / $250 CC

Single Area

$150 / $100 CC

The purpose of this consent form is to provide written information regarding the risks, benefits and alternatives of treatment to Forma. This material serves as a supplement to the discussion you have with your Crawford Cosmetics provider. It’s important that you fully understand this material, so please read this information thoroughly.

If you have any questions regarding the procedure, ask your Crawford Cosmetics provider prior to signing this consent form.

TREATMENT GOALS AND DESCRIPTION OF PROCEDURE Forma is the first auto-adjusting, non-invasive, thermal skin treatment for deep and uniform tissue stimulation. Forma induces heating of the dermal and subdermal layers of the skin, which stimulate a reaction leading to collagen generation and replenishment by using radio-frequency power that flows uniformly between the electrodes to provide a comfortable thermal experience with immediate and subsequent contraction.

TREATMENT RESULTS Most patients are pleased with the results of their Forma treatment. However, like any aesthetic procedure, there is no guarantee that you will be completely satisfied. I acknowledge that while good results are expected, I may be disappointed with the results of the procedure. I understand there is no guarantee of results of any treatment. Even though appropriate measures are taken to reduce side effects, they cannot be completely eliminated in every case. I understand that the treatment may involve risks of complication or injury from both known and unknown causes. I agree to follow the pre- and post-treatment instructions carefully. I understand that compliance with the recommended pre- and post-procedure guidelines is crucial for healing and reducing the risk of complications.

PRE FORMA INSTRUCTIONS

● Please reveal any medical conditions that may be of significance to the procedure—such as pregnancy, cold sore or fever blister tendencies, any type of allergy, recent facial peels or surgery, or any type of medication such as Accutane, or use of Retin-A.

● Cold sores require prophylactic treatment 3 days prior to your appointment. If you are prone to cold sores please call our office to get a prescription called in for you.

● Avoid self-tanning lotions and tanning beds two weeks prior to your treatment.

● Do not sunbathe two weeks prior to your appointment.

● Any patient arriving with a tan or sunburn may be rescheduled due to the sensitivity of the procedure.

● Do not use skin care products that include Retin-A, Glycolic Acid, or Retinol for 1 week prior to treatment.

● Please avoid caffeine the day of your treatment.

● Drink 8-10 glasses of water daily to keep your skin hydrated.

POST FORMA INSTRUCTIONS

● Refrain from applying any creams or liquids that have not been provided to you by Crawford Cosmetics to your skin for the first 90 minutes after your treatment.

● Keep the skin hydrated and use only lukewarm water with gentle cleansers and moisturizers for 3 days.

● Avoid use of a tanning bed for 1 week after your treatment.

● Use a minimum of SPF30 to protect your skin after treatment.

● You may have mild swelling for 1-3 days after treatment. Please apply an ice pack to the irritated area for no longer than 15 minutes, four times a day.

● Avoid prolonged sun exposure for a minimum of 2 weeks.

I will adhere to the aftercare instructions supplied to me during my visit.

FOLLOW-UP TREATMENT

● For full results, the treatment involves about 8 weekly sessions.

● Maintenance sessions may be required periodically, once every few months.

● Treatment plans may vary according to individual response..

POTENTIAL CONTRAINDICATIONS There are a few contraindications and patients with certain conditions may not be good candidates. Inform your provider if you have had any of the following conditions:

● Pregnancy or nursing

● Under 18 years of age

● Pacemaker or internal defibrillator or any electronic

● Implant such as glucose monitor

● Permanent implant in the treated area such as metal plates and screws, silicone implants or an injected chemical substance

● Current or history of cancer, especially skin cancer, or pre-malignant moles

● Impaired immune system due to immunosuppressive diseases such as AIDS and HIV, or use of immunosuppressive medications

● Severe concurrent conditions such as cancer, cardiac disorders, epilepsy, uncontrolled hypertension, and liver or kidney diseases

● Herpes Simplex (cold sores) in the treatment area (prophylactic treatment may be given).

● A history of diseases stimulated by heat, such as recurrent Herpes Simplex in the treatment area (prophylactic treatment may be given)

● Any active condition in the treatment area, such as sores, psoriasis, eczema and rash as well as excessively/freshly tanned skin

● History of skin disorders such as keloid scarring, abnormal wound healing, as well as very dry, cracked, ulcerated, infected and fragile skin

● Tattoos, permanent make-up, pigmented lesions (what want to be kept)

● Any medical condition that might impair skin healing

● Poorly controlled endocrine disorders, such as diabetes or thyroid dysfunction

● Any surgical, invasive, ablative procedure in the treatment area in the last 3 months or before complete healing

● Use of Isotretinoin (Accutane) within 6 months prior to treatment

POSSIBLE RISKS & COMPLICATIONS

● Local pain

● Skin redness

● Swelling

● Damage to the natural skin texture (crust, blister, burn)

● Change of pigmentation (hyper- or hypopigmentation)

● Scarring

PREGNANCY AND CONTRAINDICATED CONDITIONS I am not aware that I am pregnant. I am not trying to get pregnant. I am not lactating (nursing). I do not have any major illnesses which would prohibit me from receiving Forma. I do not have multiple allergies or high sensitivity to medications, including lidocaine.

ALTERNATIVE THERAPY I understand that Forma is an elective procedure with the goal of improved aesthetic appearance and that alternative procedures or methods of treatment that cause skin tightening by heating the tissue, such as lasers, IPL, and RF technologies are available. However, none of them involve skin temperature control for safety, like Forma. Details were explained to me.

PAYMENT I understand that this service is not covered by insurance, and payment is my responsibility and is expected at the time of treatment.

RIGHT TO DISCONTINUE TREATMENT I understand that I have the right to discontinue the Forma procedure at any time.

RELEASE OF LIABILITY I hereby indemnify Crawford Cosmetics, PLLC from any liability relating to the procedures that I have volunteered for. I understand that any treatment performed is between me and the doctor/ healthcare provider who is treating me and I will direct all post-treatment questions or concerns to the treating clinician. Furthermore, I hereby indemnify the facility/ meeting room/hotel where this treatment is being performed from any liability relating to the procedures that I have volunteered for.

CONSENT TO TREATMENT I hereby voluntarily consent to treatment with Forma as performed by my Crawford Cosmetics provider. I have read the above and understand it. I state that I read and write in English. I am not under the influence of drugs or alcohol. I have been fully informed by the provider/provider’s staff regarding the procedure, its possible side-effects, and pre & post-op care instructions, which are listed, but not limited to the articles listed above. It has been fully explained to me and my questions have been answered satisfactorily. I accept the risks and complications of this elective procedure and I understand that no guarantees are implied as to the outcome of the procedure. Please note this consent is valid for all future Forma treatments chosen to receive from Crawford Cosmetics.

Forma is the first auto-adjusting, non-invasive, thermal skin treatment for deep and uniform tissue stimulation. Forma induces heating of the dermal and subdermal layers of the skin, which stimulate a reaction leading to collagen generation and replenishment by using radio-frequency power that flows uniformly between the electrodes to provide a comfortable thermal experience with immediate and subsequent contraction.

PRE FORMA INSTRUCTIONS

Please reveal any medical conditions that may be of significance to the procedure—such as pregnancy, cold sore or fever blister tendencies, any type of allergy, recent facial peels or surgery, or any type of medication such as Accutane, or use of Retin-A.

Cold sores require prophylactic treatment 3 days prior to your appointment. If you are prone to cold sores please call our office to get a prescription called in for you.

Avoid self-tanning lotions and tanning beds two weeks prior to your treatment.

Do not sunbathe two weeks prior to your appointment.

Any patient arriving with a tan or sunburn may be rescheduled due to the sensitivity of the procedure.

Do not use skin care products that include Retin-A, Glycolic Acid, or Retinol for 1 week prior to treatment.

Please avoid caffeine the day of your treatment.

Drink 8-10 glasses of water daily to keep your skin hydrated.

POST FORMA INSTRUCTIONS

Refrain from applying any creams or liquids that have not been provided to you by Crawford Cosmetics to your skin for the first 90 minutes after your treatment.

Keep the skin hydrated and use only lukewarm water with gentle cleansers and moisturizers for 3 days.

Avoid prolonged sun exposure or use of a tanning bed for 1 week after your treatment.

Use a minimum of SPF30 to protect your skin after treatment.

You may have mild swelling for 1-3 days after treatment. Please apply an ice pack to the irritated area for no longer than 15 minutes, four times a day.

I will adhere to the aftercare instructions supplied to me during my visit.

POSSIBLE RISKS & COMPLICATIONS

Local pain, Skin redness, Swelling, Damage to the natural skin texture (crust, blister, burn), Change of pigmentation (hyper- or hypopigmentation), Scarring

I have been fully informed by the provider/provider’s staff regarding the procedure, its possible side-effects, and pre & post-op care instructions, which are listed, but not limited to the articles listed above. It has been fully explained to me and my questions have been answered satisfactorily. I accept the risks and complications of this elective procedure and I understand that no guarantees are implied as to the outcome of the procedure. Please note this consent is valid for all future Forma I choose to receive from Crawford Cosmetics.

Our goal is to provide quality aesthetic treatments to all our clients in a timely manner. No-shows, late arrivals, and cancellations inconvenience not only our providers, but our other clients as well. Please be aware of our policy regarding missed appointments. Your appointments and well-being are very important to us. We understand that sometimes unexpected issues arise.

Appointment Cancellation

Our policy enforces a late cancellation fee for cancellations made with less than a 72-hour notice. It is important to understand that you will forfeit your deposit for any appointment cancelled inside the 72-hour cancellation window. If you no call/no show, in addition to forfeiting your deposit, you will be charged a fee of $100. We take No call/No shows very seriously. We make all efforts to avoid these fees for you by sending multiple texts and email reminders that allow ample time to cancel or reschedule your appt with us.

When you book your appointment, you are holding a space on our calendar that is no longer available to our other clients. To hold this appointment, we require a credit card on file, and partially refundable $75 deposit for appointments under 30 mins ($67.50 will be refunded), and $200 partially refundable deposit for appointments over 30 mins ($180 will be refunded). Shorter appointments with our estheticians require a smaller deposit and are partially refundable. Other appointment deposits many vary. The deposit will be applied toward the cost of your treatment and is partially refundable if you do not receive treatment at the time of your appointment. In order to be respectful of your fellow clients, please notify your Crawford Cosmetics provider as soon as you know you will not be able to make your appointment.

Please note, if you are more then 10 minutes late for your scheduled appointment, your appointment will be automatically cancelled, you will lose your deposit, and will be charged the additional no show fee of $100.

If cancellation is necessary, we require that you call, text, or cancel online at least 72 hours in advance. Appointments are in high demand, and your advanced notice will allow another client access to that appointment time. As we are closed over the weekend, if you have a Monday appointment, we require that you cancel the Wednesday before by 5pm. If you have a Tuesday appointment, we require that you cancel the Thursday before by 5pm at the latest. Appointments are in high demand, and your advanced notice will allow another client access to that appointment time.

How to Cancel Your Appointment

If you need to cancel your appointment and are enrolled in text message reminders, you can reply "no" to the reminder text that you will receive 4 days prior to the appointment. Other options are: cancel online, call or text the scheduling line, Port Huron (248) 285-9876 or Royal Oak (248) 221-1895, during regular business hours, or text your Crawford Cosmetics provider. If necessary, please leave a detailed voicemail message and we will return your call as soon as possible. Please note, if you cancel your appointment through our automatic text message reminder or online, you must reach out to us for the refund, as is not returned automatically and remains on file unless a refund is requested.

Late Cancellations vs. No-Shows

A cancellation is considered late when the appointment is cancelled with less than 72 hours' notice. A no-show is when a client misses an appointment without cancelling.

It is important to understand that you will forfeit your deposit for any appointment cancelled inside the 72hour cancellation window. If you no call/no show, in addition to forfeiting your deposit, you will be charged a fee of $100. These fees will automatically be applied to the credit card on file. If the credit card is rejected, any fee that is owed must be paid in full prior to booking any future appointments.

I confirm that I have read, understand and agree to the above policy.