Section 1 — Treatment Overviews

The following descriptions provide a medically accurate overview of each BTL treatment available at The Whole List Doc. Please read each section carefully and ask your provider any questions before signing this form.

What It Is

BTL Exomind is a non-invasive brain stimulation therapy using focused electromagnetic pulses to target the left dorsolateral prefrontal cortex (DLPFC) — a region of the brain central to mood regulation, executive function, and cognitive performance. This technology is designed to improve mood, cognitive clarity, and overall mental wellness without the use of medication or anesthesia.

How It Works

Exomind delivers high-frequency repetitive transcranial magnetic stimulation (rTMS) to the DLPFC. Electromagnetic pulses penetrate the scalp and skull to induce electrical currents in targeted cortical neurons. Over a treatment series, this promotes long-term potentiation (LTP)-like synaptic plasticity, modulates cortical excitability, and helps normalize aberrant neural activity patterns associated with depression, anxiety, and cognitive difficulties.

Regulatory Status

BTL Exomind / rTMS technology is FDA-cleared in the United States for the treatment of major depressive disorder (MDD). Additional regulatory approvals exist in Canada and Europe for anxiety, obsessive-compulsive disorder (OCD), and related conditions.

Typical Treatment Protocol

• Approximately 6 sessions, each lasting under 30 minutes
• Sessions are spaced 3–7 days apart as clinically indicated
• Patient remains seated and fully awake throughout; no anesthesia, sedation, or recovery time required

Expected Benefits

• Improved mood and reduced depressive symptoms
• Cognitive enhancement and mental clarity
• Long-term neurological balance and resilience
• Non-pharmacological support for mental wellness

What It Is

BTL Emsculpt Neo is a first-of-its-kind, non-invasive body contouring device that simultaneously combines two clinically validated technologies: Radiofrequency (RF) and High-Intensity Focused Electromagnetic technology (HIFEM®). It is designed to reduce subcutaneous fat and increase muscle mass in a single treatment session with no surgery or downtime.

How It Works

The RF component heats adipose (fat) tissue to 43–45°C, triggering apoptosis (permanent, programmed fat cell death) while simultaneously warming the underlying musculature to 40–41°C to enhance muscle contraction efficiency. The HIFEM® component induces supramaximal muscle contractions — contractions of an intensity impossible to achieve through voluntary exercise — stimulating muscle hypertrophy and hyperplasia. The dual simultaneous emission produces synergistic results superior to standalone treatments of either modality alone.

Clinical Results

• Average 30% reduction in subcutaneous fat per published clinical studies
• Average 25% increase in muscle thickness per published clinical studies
• Approximately 19% reduction in diastasis recti (abdominal muscle separation)

Typical Treatment Protocol

• 4 sessions, each lasting approximately 30 minutes
• Sessions are spaced 5–10 days apart as clinically indicated
• No anesthesia, sedation, or downtime required

Expected Benefits

• Visible muscle building and fat reduction
• Improved overall body composition
• Skin tightening over the treatment area
• Improved posture, core strength, and functional fitness

What It Is

BTL Emsella is a non-invasive pelvic floor strengthening device using High-Intensity Focused Electromagnetic technology (HIFEM®). The patient remains fully clothed throughout the entire session, seated comfortably in the Emsella chair. It is designed to address urinary incontinence, pelvic floor weakness, and associated conditions in both male and female patients.

How It Works

Each 28-minute session delivers approximately 11,000 supramaximal pelvic floor contractions — far exceeding what voluntary exercise (including Kegel exercises) can achieve. This high volume of contractions rebuilds pelvic floor muscle strength, restores neuromuscular control, and comprehensively addresses stress, urge, and mixed urinary incontinence.

Regulatory Status

BTL Emsella is FDA-cleared for the treatment of urinary incontinence in both male and female patients and for pelvic floor rehabilitation.

Typical Treatment Protocol

• 6 sessions over 3 weeks, with 2 sessions per week
• Each session is approximately 28 minutes in duration
• No downtime, preparation, or recovery period required

Expected Benefits

• Significant strengthening of pelvic floor musculature
• Reduced or eliminated urinary incontinence episodes
• Improved bladder control and urgency management
• Enhanced sexual function and confidence

Section 2 — Contraindications

The following conditions may prevent or limit your eligibility for one or more of the treatments offered. Your provider will review your full medical history prior to treatment. It is your responsibility to disclose all known medical information. Providing incomplete or inaccurate medical history releases The Whole List Doc of clinical liability for adverse outcomes attributable to undisclosed contraindications.

✕ = Contraindicated    — = Not applicable for this treatment

Section 3 — Risks and Side Effects

All medical and aesthetic treatments carry some degree of risk. The following information summarizes the known and reported risks associated with each BTL treatment, stratified by frequency of occurrence. Please review each section applicable to your selected treatment(s).

Common (likely to occur in some patients)

• Mild headache during or after the treatment session
• Scalp discomfort or sensitivity at the stimulation site
• Scalp sensations, tingling, or mild pressure during stimulation
• Audible clicking sounds from the TMS device during stimulation (normal and expected)
• Mild muscle contractions in the scalp or face during stimulation
• Temporary lightheadedness following treatment

Less Common (may occur in a minority of patients)

• Elevated mood or hypomania-like state (patients with bipolar history should disclose prior to treatment)
• Temporary facial muscle twitching near the stimulation site
• Paradoxical transient reduction in efficacy if stimulation parameters are excessive — addressed through provider protocol adjustment

Rare (infrequent but possible; reported in literature)

• Seizure: Extremely rare in properly screened, eligible patients. Absolute risk is very low. Comprehensive contraindication screening is performed prior to treatment initiation to minimize this risk to the greatest extent possible.

Common (likely to occur in some patients)

• Mild to moderate muscle soreness, similar in character to an intense workout; typically resolves within 24–72 hours
• Temporary redness or warmth over the treatment area from RF energy; fades within hours after the session
• Muscle twitching or spasms during and briefly after treatment (normal physiologic response to HIFEM® stimulation)

Less Common (may occur in a minority of patients)

• Mild joint or tendon discomfort near the treatment site
• Panniculitis — a rare, typically self-limiting inflammation of subcutaneous fat tissue
• Temporary increase in menstrual flow in female patients
• Temporary localized swelling over the treatment area

Rare (infrequent but possible; reported in literature)

• Skin burns: Risk is increased over scar tissue; your provider will take additional precautions in such areas
• Injury to underlying tissues or structures (exceedingly rare with proper application)

Common (likely to occur in some patients)

• Muscle soreness or heavy sensation in the pelvic region following treatment
• Mild spasms or tingling during and after the session
• Localized warmth or mild redness in the pelvic or inner thigh area

Less Common (may occur in a minority of patients)

• Temporary discomfort in nearby joints or tendons (e.g., hip or sacroiliac region)
• Temporary digestive changes such as mild diarrhea or constipation due to proximity to pelvic musculature

Rare (infrequent but possible; reported in literature)

• Muscle overload with prolonged weakness or extended recovery time between sessions (addressed by adjusting treatment intensity)

Section 4 — Pre-Treatment Care Instructions

Please follow the instructions below prior to each treatment session. Adhering to these guidelines will optimize your safety, comfort, and treatment outcomes. Inform your provider if you are unable to follow any of these recommendations.

• Continue all regular medications unless specifically advised otherwise by your provider
• Avoid alcohol, recreational substances, and smoking on the day prior to and the day of each treatment session
• Limit caffeine intake (coffee, tea, energy drinks) on the day of each session
• Arrive well hydrated and well rested; fatigue and dehydration can affect tolerability
• Inform your provider of any new medications, supplements, or changes in health status since your last session
• Remove all metal objects from the head and neck area prior to treatment

• Arrive with clean skin on the treatment area — free of lotions, creams, oils, or SPF products
• Do not apply any topical products to the treatment area on the day of service
• Remove all jewelry, body piercings, and electronic devices (including fitness trackers) before the session
• Disclose all metal implants, IUDs, or internal devices prior to each session — even if previously disclosed
• Avoid treatment if you have had recent surgery in the treatment area without physician clearance
• Eat a light, healthy meal 1–2 hours before your session; avoid heavy meals immediately prior

• Wear comfortable, loose-fitting clothing to facilitate ease of positioning in the Emsella chair
• No special preparation is required — you will remain fully clothed throughout the entire session
• Empty your bladder immediately before the treatment begins for comfort and to maximize treatment effectiveness
• Avoid scheduling treatment during active menstruation
• Disclose any new IUD placement, pelvic surgery, or changes in pelvic health prior to each session

Section 5 — Post-Treatment Care Instructions

Following each treatment session, please observe the guidelines below. If you experience any unexpected, prolonged, or concerning symptoms, contact The Whole List Doc immediately or seek emergency care as appropriate.

• Stay well hydrated after each session; drink water throughout the remainder of the day
• Rest if needed — listen to your body and avoid overexertion following your first session
• For mild headache or scalp discomfort, over-the-counter pain relief (e.g., acetaminophen) may be used as directed on the packaging
• Avoid excessive cognitive or sensory stimulation immediately after your first one to two sessions as your brain acclimates to the therapy
• Contact the clinic immediately if you experience prolonged headache, persistent dizziness, confusion, unusual mood changes, or any symptom that feels abnormal
• In an emergency, call 911 or proceed immediately to your nearest emergency room

• Mild to moderate muscle soreness lasting 24–72 hours is normal and expected — this is a sign that your muscles have been effectively stimulated
• Stay well hydrated and maintain a healthy, balanced diet to support fat elimination and optimal muscle recovery
• Gentle activity (walking, light stretching) is permitted immediately following treatment
• Avoid anti-inflammatory medications (e.g., ibuprofen, naproxen) for 24 hours post-treatment unless medically necessary — the inflammatory process plays a role in the body's fat elimination mechanism
• Contact the clinic promptly if you experience prolonged pain, persistent redness, swelling, blistering, or any symptoms that feel unusual or disproportionate

• No aftercare is required — you may resume all normal daily activities immediately after each session
• Mild pelvic muscle fatigue, tingling, or a sensation of heaviness may persist for a few hours and is entirely normal
• Results are progressive and cumulative — improvement typically builds across the full treatment series and continues to develop for several weeks after the final session
• Practice pelvic floor exercises (Kegel exercises) between sessions to support and enhance your treatment outcomes
• Contact the clinic if you experience any unexpected, prolonged, or unusual symptoms in the pelvic region

Section 6 — Acknowledgment of No Guarantees

I understand and acknowledge each of the following statements regarding treatment outcomes:

1. Results of all BTL treatments vary by individual and are dependent upon multiple factors, including but not limited to: baseline health status, body composition, age, lifestyle habits, adherence to the full treatment protocol, and individual biological response to electromagnetic and radiofrequency stimulation.
2. No specific outcome, result, timeline, or number of treatment sessions has been promised, guaranteed, or warranted to me by The Whole List Doc or any of its clinical staff.
3. My provider has explained the expected range of outcomes based on published clinical data and peer-reviewed studies; however, I understand that clinical data reflects averages across patient populations and does not predict or guarantee my individual result.
4. Additional sessions, maintenance treatments, or complementary approaches may be recommended by my provider to achieve or sustain my desired outcome — such recommendations do not constitute a prior guarantee that fewer sessions would have been sufficient.
5. The Whole List Doc shall not bear responsibility for outcomes that fall outside my personal expectations when treatment has been performed in accordance with accepted clinical protocols, applicable device manufacturer guidelines, and standard of care for the relevant discipline.

Section 7 — Payment and Cancellation Policy

By signing this consent form, you acknowledge and agree to The Whole List Doc's payment and cancellation policies as described below:

1. Payment at Time of Service. Payment in full is required prior to or at the time of each service, unless a written financing arrangement or payment plan has been established with The Whole List Doc in advance of treatment.
2. Non-Refundable Treatment Packages. Treatment packages are non-refundable once any session within the package has been initiated, regardless of usage or completion status. By commencing treatment, the patient acknowledges acceptance of this policy.
3. Cancellation Policy. Individual sessions must be canceled with a minimum of 24 hours' advance notice to avoid a late cancellation fee. Cancellations made with less than 24 hours' notice may result in a fee equivalent to the per-session value of the treatment.
4. No-Show Policy. Failure to appear for a scheduled session without prior notification (a "no-show") may result in forfeiture of that session without credit or refund.
5. Medically Indicated Discontinuation. The Whole List Doc reserves the right to discontinue treatment at any time if a patient is found to have an undisclosed contraindication, if a new contraindication develops, or if continuation of treatment is no longer medically advisable in the clinical judgment of the treating provider. In such cases, a prorated refund for unused sessions may be issued at management's discretion.
6. Agreement to Policy. By signing this form, the patient confirms they have read, understood, and agree to The Whole List Doc's payment and cancellation policies as stated above.

Section 8 — HIPAA Notice and Privacy Authorization

1. Commitment to Privacy. The Whole List Doc is fully committed to protecting the privacy and security of all patient health information in compliance with the Health Insurance Portability and Accountability Act (HIPAA) of 1996 and all applicable federal and state privacy laws.
2. Notice of Privacy Practices. The Whole List Doc's Notice of Privacy Practices (NPP) is available upon request at the front desk and describes in full how we collect, use, store, and safeguard your protected health information (PHI). A copy will be provided to you upon request at no charge.
3. Acknowledgment of Receipt. By signing this consent form, you acknowledge that you have received, or have been given access to, The Whole List Doc's Notice of Privacy Practices.
4. Permitted Uses of PHI. Your protected health information may be used and disclosed for the purposes of treatment, payment, and healthcare operations as permitted under HIPAA without additional written authorization from you.
5. Your Rights. You have the right to: access your medical records; request corrections to your records; request an accounting of disclosures; request restrictions on certain uses and disclosures; and file a complaint with The Whole List Doc or the U.S. Department of Health and Human Services if you believe your privacy rights have been violated. These rights are described in full in the Notice of Privacy Practices.
6. Marketing and Photography. Any marketing photography consent provided separately in Section 6 of this form does not constitute a HIPAA authorization for the release of your protected health information. All promotional materials will be de-identified and stripped of all PHI in compliance with HIPAA de-identification standards prior to any public use.