AI WELLNESS CENTER OF EXCELLENCE
T2 BY BALDAN® CONSENT
BODY CONTOURING & SKIN SCULPTING
INFORMED CONSENT & AUTHORIZATION

This consent form confirms that I have been informed about the T2 by Baldan body contouring and skin sculpting treatment, including how it works, potential benefits, expected limitations, contraindications, risks, alternatives, and my responsibilities as a patient. This information allows me to make an informed and voluntary decision regarding treatment at AI Wellness Center of Excellence.

DESCRIPTION OF T2 BY BALDAN SYSTEM

I understand that T2 by Baldan is a non-invasive body contouring and shaping system that uses a multi-technology platform to support improvements in localized body contour, skin texture, and tissue tone. The device integrates multiple technologies that may be used simultaneously during a session, including:

• Bipolar Radiofrequency (RF): Controlled heating of the skin and subdermal tissues, which may support collagen stimulation and firmness.
• Low-Level Laser Therapy (LLLT / Photobiomodulation): Light energy delivered to tissues to support cellular activity, circulation, and metabolic processes.
• Vacuum / Endodermic Massage with Mechanical Stimulation: Suction and mechanical movement intended to support circulation, lymphatic flow, and contour refinement.
• Optional Mesoporation or Micro-Vibration Functions: Depending on the handpiece, penetration and tissue stimulation technologies that support overall treatment effects.

I understand that T2 treatments are designed to support body contouring, improvement in the appearance of cellulite, and localized tissue quality enhancement through these synergistic, non-invasive modalities.

I understand that T2 is not a surgical procedure and is performed without anesthesia, needles, or incisions.

INTENDED BENEFITS (NO GUARANTEES)

I understand that potential benefits of T2 treatments may include improved body shape and contour, improvement in localized skin laxity, enhanced firmness and skin tone, reduction in the appearance of cellulite, improved micro-circulation and lymphatic drainage, and support for overall skin texture and radiance. Individual results vary.

I understand that T2 treatments are aesthetic in nature and do not treat medical conditions such as obesity, systemic disease, or metabolic disorders.

TREATMENT AREAS

I understand that T2 may be used on various body areas including, but not limited to, the abdomen, thighs (inner and outer), buttocks, arms, flanks, back, and hips. Treatment areas will be determined by the provider based on my concerns and anatomy.

TREATMENT SERIES & FREQUENCY

I understand that multiple sessions are typically required to achieve optimal results.

I understand that treatment plans often involve a series of sessions that may be performed one to two times per week over several weeks, depending on my goals, treatment area, and provider recommendation.

I understand that results are gradual and cumulative and may require ongoing or maintenance treatments for long-term contouring support.

LIMITATIONS & EXPECTATIONS

I understand that T2 is not a weight-loss solution, is not a substitute for diet, exercise, or surgical body contouring, and does not guarantee fat loss, circumference changes, or specific results.

I understand that aesthetic and contouring treatments are not exact sciences, and no specific outcome, measurement change, or duration of effect can be guaranteed.

ALTERNATIVES

I understand that alternatives to T2 treatment include no treatment, diet and exercise programs, other non-invasive body contouring technologies, or injectable or surgical contouring procedures. These alternatives have been discussed with my provider.

CONTRAINDICATIONS & PRECAUTIONS

I understand that T2 treatments may not be appropriate without medical clearance if I am pregnant or breastfeeding, have implanted electronic devices, metal implants in the treatment area, active cancer or a history of cancer, severe vascular disease, severe skin conditions, recent surgery in the treatment area, uncontrolled medical conditions, compromised immune function, or neurological disorders that could be aggravated by electrical or mechanical stimulation.

I understand that it is my responsibility to disclose all health conditions, medications, supplements, and implants prior to treatment.

RISKS & POSSIBLE SIDE EFFECTS

I understand that T2 treatments are generally well tolerated; however, possible side effects may include temporary redness, warmth, heat or tingling sensations, swelling, tenderness, temporary skin sensitivity or numbness, muscle soreness, bruising, petechiae, tissue marking, or temporary changes in sensation.

I understand that most side effects are temporary and resolve with time and appropriate care. Rare or unforeseen complications may occur, and individual responses vary.

I agree to notify AI Wellness Center of Excellence immediately if I experience unusual symptoms, persistent pain, blistering, or skin changes.

POST-TREATMENT RESPONSIBILITIES

I understand that adequate hydration, proper nutrition, and adherence to post-care instructions may support optimal results and reduce the likelihood of complications.

I agree to allow the clinic to participate in my care for any concerns related to this treatment.

FINANCIAL & NO REFUND POLICY

I understand that payment is for professional services rendered and not for guaranteed outcomes, and that there are no refunds for patient-determined unsatisfactory results.

PROVIDER AUTHORIZATION

I authorize Dr. Gideon Kwok, D.O., and/or trained and qualified medical associates acting within their scope of practice to perform T2 by Baldan body contouring and skin sculpting treatments on me.

I confirm that I have had the opportunity to ask questions regarding provider qualifications and am satisfied.

VOLUNTARY CONSENT & FINAL ACKNOWLEDGMENT

I certify that I have read, understood, and agree to the contents of this consent form. This document supersedes any prior verbal or written disclosures, and I freely consent to T2 by Baldan body contouring treatments.