Patient Name: *

Date of Birth: *

Procedure Date: *

Introduction

Profhilo® is an injectable skin remodeling treatment that delivers high concentrations of hyaluronic acid to improve skin hydration, elasticity, and overall quality. It stimulates collagen and elastin production for a natural-looking rejuvenation effect.

Procedure

Profhilo® is injected in specific points of the treatment area using a fine needle. The product spreads beneath the skin to hydrate and stimulate collagen production. Typically, two sessions are recommended, spaced four weeks apart.

Potential Risks & Side Effects

I understand that, as with any injectable treatment, there are possible risks, including but not limited to: *

Redness, swelling, or bruising at the injection sites

Mild tenderness or discomfort

Temporary lumps or uneven skin texture

Infection (rare but possible)

Allergic reactions (though uncommon)

Pre-Treatment Instructions *

Avoid alcohol, aspirin, ibuprofen, and other blood-thinning medications for at least 24 hours before treatment unless medically necessary.

Inform the practitioner of any medical conditions, allergies, or medications.

Arrive with clean skin, free of makeup and skincare products.

Post-Treatment Care

Post-Treatment Care *

Avoid touching, massaging, or applying pressure to the treated area for at least 24 hours.

Apply ice packs if needed to reduce swelling.

Avoid excessive sun exposure and use SPF 30+ sunscreen daily.

Avoid strenuous exercise, saunas, and swimming for 24-48 hours.

Follow any additional aftercare instructions provided.

Acknowledgment & Consent *

I confirm that I have read and understood the information provided. I have discussed any questions or concerns with my provider. I acknowledge that results vary between individuals and that multiple treatments may be necessary for optimal results. I consent to proceed with the Profhilo® treatment.

Date: *

Patient Signature: *

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Provider/Practitioner Name: *

Provider Signature *

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I agree to terms & conditions provided by the company.

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