PATIENT AGREEMENT
Is scalp cooling right for me?
- I understand that scalp cooling may cause pain or discomfort with extreme cold sensitivity, which
typically diminishes within the first 30 minutes of treatment. - I understand there are special hair care recommendations.
- I understand that treatment scheduling will depend on machine availability.
- I will need to have a cap fitting done prior to the first treatment.
- I understand that if I use this service it will require additional time after the infusion (60-180 minutes).
- I understand that the goal of treatment with DigniCap is less than 50% hair loss.
- I am aware that shedding will occur and that DigniCap will not completely prevent hair loss.
- I understand that the amount of hair loss is dependent on several factors including the chemotherapy regimen, dosage, duration of drug infusion, chemotherapy drug, metabolism, and other medical conditions.
- I understand that insurance may not cover the cost of scalp cooling treatments.
- I have discussed the DigniCap contraindications and warnings with my provider and understand these risks.
- I understand that scalp cooling results are variable and that there is no guarantee of success.
OPERATIONS
Dignitana
10925 Estate Lane, Suite W185
Dallas, TX 75238
+1 877-350-2150
HEADQUARTERS
Dignitana AB
Traktorgränden 3
226 60 Lund, Sweden
+46 46 16 30 90
ITALY HQ
Dignitana S.r.l.
Corso di Porta Nuova, 46
20121 Milan, Italy