COOL MED SPA
COOLSCULPTING AND BODY CONTOURING
Do you have any of the following?
» Cryoglobulinemia or paroxysmal cold hemoglobinuria Yes / No
» Known sensitivity to cold such as cold urticaria or Raynaud’s disease Yes / No
» Impaired peripheral circulation in the area to be treated Yes / No
» Neuropathic disorders such as post-herpetic neuralgia or diabetic neuropathy Yes / No
» Impaired skin sensation Yes / No » Open or infected wounds Yes / No
» Bleeding disorders or concomitant use of blood thinners Yes / No
» Recent surgery or scar tissue in the area to be treated Yes / No
» A hernia or history of hernia in the area to be treated or adjacent to treatment site Yes / No
» Skin conditions such as eczema, dermatitis, or rashes Yes / No
» Pregnancy or lactation Yes / No
» Any active implanted devices such as pacemakers and defibrillators Yes / No
If you answered yes to any of the above questions, you may not be the best candidate for the Coolsculpting procedure. Be sure to discuss any medical condition you have with the treating doctor before undergoing any medical procedure.