CONSENT FOR COOLSHAPING

First Name

Last Name

NRIC (Last 4 Digits)

Phone Number

Explanation of Coolshaping 2 Fat Freeze Procedure: *

Explanation of Coolshaping Procedure:
The Coolshaping 2 is a medical device KFDA Approved . The procedure utilizes high precision 360 cooling technology that can safely and effectively reduce and eliminate fat cells from specific areas of the body. Coolshaping2 can deliver significant fat layer reduction in these targeted areas which help to contour the body and reclaim its natural shape. This procedure is non-invasive with no anesthesia or recovery time. During the procedure tissue is drawn into a cup with vacuum pressure that may cause some discomfort or an unfamiliar sensation. Patients may also experience an uncomfortable cold sensation that typically subsides within 10-12 minutes after the procedure begins. If an excessively painful sensation is felt during the procedure please notify your therapist immediately. Once the procedure is complete, patients can immediately return to their normal activities, including work or exercise.

Please read the following statements carefully *

I understand that this procedure is cosmetic and is purely elective, that the results are not guaranteed and results may vary with each individual.

I understand that multiple treatments may be necessary.

I acknowledge that I am a competent, consenting adult of at least 18 years of age.

I consent to photographs for my record of the procedure area.

I understand that I have the right to consent or refuse any proposed procedure at any time prior to its performance.

The suction pressure may cause sensation of deep pulling , tugging and pinching. You may experience intense stinging , tingling , aching or cramping as the treatment begins. These sensation generally subside as the area become numb .

The treatment area may look or feel stiff after the procedure and transient blanching ( Temporary whitening of the skin ) may occur . You may feel a sense of nausea or dizziness as your body naturally warms and sensation returns to your treatment area . These are normal reaction that typically resolve within minutes

Bruising , swelling , tenderness can occur in the treated area and it may appear red for a few hours after the applicator is removed

You may feel a dulling of sensation in the treated area that can last for several weeks after your procedure . Other changes - including deep itching , tingling , numbness , tenderness to the touch , pain in the treated area , strong cramping , muscle spasms , aching and soreness also have been reported after a Coolshaping procedure treatment .

You may start to see changes as early as three weeks after Coolshaping . and you will experience the results after one to three months. Your body will continue naturally to proces the injured fat cells from your body for up to 4 months after your procedure .

Do you have any of the following ? ( If ANY , you are NOT SUITABLE for this treatment )

Cryoglobulinemia or paroxysmal cold hemoglobinuria ?

Pregnant or breastfeeding ?

Known sensitivity to cold such as cold urticaria or Raynaud's disease

Impaired peripheral circulation in the area to be treated ?

Neuropathic disorder such as post - herpetic neuralgia or diabetic neuropathy ?

Impaired Skin Sensataion

Paradoxical Adipose Hyperplasia (PAH ). This condition causes a gradual enlargement of the treated area. It occurs when the stimulus (the freezing of fat cells) activates a reactionary process in the fatty tissue that thickens and expands the fat cells rather than breaking them down and allowing the body to process and remove them.

Submission *

By submitting this consent form, I confirm I have read this consent form and the consent form has been explained to me in terms which I understand. I understand the risks associated with this procedure and am aware there are alternative treatments available and would like to proceed with this treatment today. I understand this is not a medical procedure. Coolshaping2 by The Lash Chapter is a cosmetic procedure and is not covered by any health insurance plan. I accept responsibility for all costs associated with this procedure and no refunds will be given .

mia seputra

07:29 22 Apr 23

Have been going to this place for my lash lift in the last 2 years, and always happy with the result. all therapist are nice, and good. This time Linh handle my lash lift and result is nice! The place is also just refurbished, more space and convenient. Thanks Lash Chapter!

Jasmine Apryl Tan

11:45 07 Feb 23

Had such a fantastic experience here with Moon my stylist, place was peaceful and quiet too. Moon was very gentle and made sure that I was comfortable throughout. Would come back again for her service. Thank you!

Rachel Ng

07:26 18 Jan 23

I have been to a lot of places to get my lash lift done and not a single place managed to lift my lashes as they claim it’s too coarse, too straight etc. Not until I visited The Lash Chapter! Finally a place that is able to properly lift my lashes up nicely. The lash lift usually lasts for about 6-8 weeks and my go to tech is Moon.

Rachel Yong

07:06 14 Jan 23

Very satisfying service by Moon, she has been helping me do eyelash lift+tint and eyelid tattoo. Nice to see their salon has also recently done renovation, with good ambience.

Emily Loh

06:59 07 Jan 23

My go to place for lash lift everytime, that provides me with long lasting curls. Experience is great - they recently revamped the place so it’s even better and more comfortable!

Vaness Wong

04:20 07 Jan 23

My lashes are beautiful after getting a lash lift here. Would definitely recommend!

Kellie

12:13 31 Aug 22

Highly recommend Moon, one of the best therapist/beautician from TLC. My second visit to TLC but this time at the Delfi Orchard outlet, for a touch up within less than a week, as my lashes were not evenly lifted from my first visit at a different outlet. I am grateful for her amazing job and definitely will return to her for future lash lifts. ✨️✨️

Rennie Lee

10:24 11 Aug 22

Visited a couple of weeks ago for a lash lift treatment (natural look). Very satisfied with how it turned out! It’s been about 2 weeks and they still look good. The consultants were very nice and accommodating. In my first visit around 1 month plus ago, my lashes weren’t in such a good condition from a previous lash lift elsewhere. They advised me to take a break first and reschedule. Thanks!!

Promo Code: Thelashchapter10

YOUR CART

CONSENT FOR COOLSHAPING

Google Reviews By Trusted Customers

SUBSCRIBE TO OUR NEWSLETTER TO RECEIVE PROMOTIONAL DEALS !

LOCATE US (5 OUTLETS)

SITELINKS

SOCIAL MEDIA

© 2017-2025 The Lash Chapter SG Pte Ltd. All Rights Reserved | Web Design by OOm

WHAT ARE YOU LOOKING FOR?

Promo Code: Thelashchapter10

YOUR CART

CONSENT FOR COOLSHAPING

Google Reviews By Trusted Customers

SUBSCRIBE TO OUR NEWSLETTER TO RECEIVE PROMOTIONAL DEALS !

LOCATE US (5 OUTLETS)

SITELINKS

SOCIAL MEDIA

© 2017-2025 The Lash Chapter SG Pte Ltd. All Rights Reserved | Web Design by OOm

WHAT ARE YOU LOOKING FOR?

LOGIN

SIGN UP​​

SIGN UP