CMSlim™ HI-EMT Consent Form
Product/Treatment Information:
CMSlim™ HI-EMT uses a specific range of electromagnetic frequencies that force muscles to maintain a contracted state for several seconds at a time over a 30-minute treatment. Muscle tissue and fat cells must adapt when repeatedly exposed to these high-load conditions. Studies indicate that one to two months after a HI-EMT treatment course, the average muscle mass is increased by 18%, and localised fat is reduced by 21%, although this can vary from person to person.
During normal exercise (voluntary muscle contractions), the muscles relax between each action as the central nervous system does not have the ability to signal another impulse while one is still in action. Maximal voluntary contractions are the highest amount of tension that can be created and held psychologically under normal conditions and generally use 30% of the muscle's ability.
CMSlim™ produces supra-maximal muscle contraction through electromagnetic impulses that are independent of brain function at a rapid rate that doesn’t allow for the relaxation phase. Supra-maximal contractions produced by the CMSlim™ device will utilise 100% of the muscle ability 100% of the time, which drastically increases the physiological workload required for muscle growth.
The supra-maximal contractions force the muscle to adapt and illicit the growth of myofibrils and the creation of new muscle fibres and protein strands. This leads to increased muscle density and volume, which in turn leads to muscle tone and definition.
The CMSlim™ body treatment also has an effect on fat through the natural effect of induced metabolism. Muscles need energy to produce contractions, and this energy is derived primarily from adenosine triphosphate (ATP) and secondarily from creatine phosphate and glycogen, which fuel the muscles. When these are depleted, the body’s catabolic processes take place in the form of lipolysis – i.e. the breakdown of stored fat cells into free fatty acids and glycerol. These released molecules are energy sources for increased muscle activity and body metabolism.
As a result, the supra-maximal muscle contractions induced by The CMSlim™ encourage the localised fat to breakdown to provide energy directly to the targeted muscle; this leads to a slimmer profile overlying a more toned muscle definition.
CMSlim™ can be used on the following body areas:
Abdomen
Buttocks
Front of the thighs
Back of the thighs
Inner Thighs
Calves
Biceps
Triceps
Shoulders
Treatment Course:
You will require an initial course of 6 treatments spaced 24 hours or more apart. This course must be completed within 2-3 weeks of starting for the accumulative effect to occur. If you do not attend all treatment sessions or leave a larger interval, you may not achieve the desired result or have to start the course of 6 again.
In order to maintain your CMSlim™ treatment results, we advise that you return for single 3-4 monthly treatments. Maintenance treatments can be given as often as once a month. It is also advised to exercise regularly between treatments.
Alternative Treatments:
Your practitioner will always advise you of the safest and most effective treatment based on your medical history and assessment. However, you should also consider the option of no treatment at all. Alternatively, other treatment options for body contouring exist, including HIFU and Aqualyx Fat reduction treatments, as well as surgical options outside our clinic. Please discuss these options with your practitioner if you wish to explore alternative options.
You cannot have CMSlim™ treatment if:
You have any metal in the intended treatment area.
You think you could be pregnant, are pregnant, or are lactating or breastfeeding.
You are trying to conceive.
You have a metal contraceptive IUD coil (Abdominal treatment area).
You are menstruating at the time of treatment - which may result in excessive menstrual bleeding.
You have a history of brain damage or brain injury.
You have a history of stroke.
You have a history of cancerous tumours
You have a pacemaker or stent
You have a spinal or bladder stimulator
You have a wound that has not completely healed in the intended treatment area.
You have any vascular disorders?
You have heart disease.
You have severe liver or kidney disease
You have a fever or feel unwell
You have uncontrolled epilepsy
Material Risk (the level of significance you personally apply to the risks, side effects or complications of this treatment within your own circumstances):
As with any medical procedure, this treatment carries the risk of side effects or complications. Discuss these risks with your practitioner to fully comprehend their implications. Consider the risks in relation to your personal circumstances, including your health, lifestyle and career and decide if they are acceptable. If not, discuss alternatives or take more time to decide.
Associated Risks:
Treatment site pain, swelling, redness, local numbness or itching. These symptoms are usually mild and last less than a few hours but can last longer.
Muscle soreness. You could experience muscle soreness for a few days following your treatment.
Temporary muscle spasm. These symptoms are self-limiting and will settle within a few days.
Temporary muscle weakness. These symptoms are self-limiting and will settle within a few days.
Temporary joint or tendon pain. These symptoms are self-limiting and will settle within a few days.
Intra-muscular fat reduction. Localised fat reduction is often seen as a positive effect of the treatment; however, you should be prepared that you may lose fat in the treatment area as a natural side of muscle stimulation.
Stimulation of the menstrual cycle/excessive menstrual bleeding. To avoid this side effect, it is important not to receive CMSlim™ HI-EMT treatments when you are due to begin or are within your menstrual cycle.
Little to no effect. Very rarely, CMSlim™ HI-EMT treatments will produce little to no effect and are not a result of the treatment being ineffective. The treatment relies upon natural metabolic pathways of the human body and, as a result, has limitations of effectiveness, and results will vary from person to person. If you feel this is the case for you, it should be discussed with your practitioner at your earliest convenience. Whilst we will endeavour to meet the expectations discussed in your consultation, there is no guarantee the treatment will meet these expectations, and no refunds will be given in this case.
Photographs:
We need to take photos of the treatment area to document the original condition before treatment begins and to monitor results and potential changes throughout the treatment process. These photos will become part of your medical aesthetic treatment record at Lumiere Medispa.
You have the right to refuse consent for these photographs. However, please be aware that without this consent, we will not be able to treat you for medico-legal reasons.
If we wish to use your photos for any other purpose, we will always seek separate written consent from you. You have the right to refuse this additional use of your photos, and it is not mandatory to consent to any other photo usage to receive treatment.
Informed Consent:
This consent form is not meant to include all possible risks associated with a CMSlim™ HI-EMT treatment, as there are both known and unknown side effects and complications associated with any medical treatment. We have written this consent form to ensure you are fully informed of the procedure, reasons why you may not be able to receive treatment and known risks of a CMSlim™ HI-EMT treatment.
By signing this consent form, you acknowledge and confirm the following:
Risks and complications
You have discussed the potential risks and benefits of a CMSlim™ HI-EMT treatment with your practitioner, and your questions have been answered satisfactorily.
You understand that medical attention may be required to resolve any complications associated with your treatment. In most cases, except those in an emergency, you should contact you practitioner for advice/treatment.
Medical History
To the best of your knowledge, you have provided the details of your past medical history and will inform your practitioner if this changes before any future treatments.
You understand that withholding aspects of your medical history could lead to serious physical and mental harm.
Contraindications & Cautions
You are not pregnant or possibly pregnant, lactating or nursing, and you will inform your practitioner if this changes before any future treatments.
Fees & Charges
You understand and agree that all services rendered will be charged directly to you, and you are personally responsible for payment.
You further agree, in the event of non-payment, to bear the cost of collection, court costs and reasonable legal fees, should they be required.
Refunds
Fees charged for treatment are for the delivery of a treatment and the accompanying service, which is inclusive of the following;
-Consultation and assessment
-The provision of information and advice
-The provision of the treatment itself, as described above
-Follow-up appointments and aftercare advice and support as appropriate
Whilst we undertake to provide excellent service, factual, honest and ethical advice, safe, expert treatment in experienced hands and only the best products, we cannot guarantee your results and cannot offer refunds if the results achieved fail to meet your expectations. The successful outcome varies by degree, and how long these effects last varies from one individual to another and cannot be guaranteed.
You understand that whilst you have been advised of a probable result, this should not be interpreted as a guarantee.
You will contact your practitioner if you are unsatisfied with your treatment outcomes.
Aftercare
You have verbally discussed the aftercare required following a CMSlim™ HI-EMT treatment and have been informed that you will also receive this via email. You understand the importance of following the post-treatment advice and agree to follow it.
You understand that failure to follow this advice could lead to serious physical and mental harm.
Photograph Use Consent:
You understand that receiving treatment at Lumiere Medispa requires photographs to be taken of the treatment area. These photographs may be taken before, during, and after each treatment and will form part of your legal medical record at Lumiere Medispa. By signing below, you freely give your consent for your photos to be used solely for this medico-legal purpose. If we wish to use your photos for any other purpose, we will always seek separate written consent from you, and you have the right to refuse.
Valid Consent
By signing below, you acknowledge that you have read and understood this consent form and have had the opportunity to discuss any questions you have with your practitioner to your satisfaction. You consent to receive a CMSlim™ HI-EMT treatment under the terms of this consent form and understand that you have the right not to consent to this treatment and that your consent is voluntary.
