In adherence with Board Rule 1.17 and HB 25-1024, our spa J Marie Skin Studio and its Medical
Director, Michael R. Iannotti, MD, are offering you medical grade aesthetic services delegated from a
Physician to licensed and unlicensed persons/delegatees who are trained and certified. This notice is to
inform you of the following, all standard and usual and customary according to the Board Rule and HB:

1. Michael R. Iannotti, MD is our Medical Director, Board Certified in Family Medicine and
extensively trained in medical grade aesthetic consultations and treatments, and

2. Dr. Iannotti delegates his licensure and authority to practice to the contractors/employees,
licensed and unlicensed, of this aesthetic spa, so he/she may provide services to you today, such
that the licensed and unlicensed persons are trained and certified and delegated authority by a
licensed Physician, and

3. Any delegatee whom practices outside of his/her scope of practice, does so per Dr. Iannotti’s
authority with training and advanced certification from third party agencies, and

4. Dr. Iannotti is available for pre-treatment advice, consultation or post-treatment advice, complication
treatment, remedy or consultation and his phone number is: 303-929-9771 and his
email is: iannotmr@hotmail.com.

5. Patients may file complaints at DORA, https://dora.colorado.gov/.

6. Copy of this information may be also found at this medi spa website.

7. Copy of this informed consent will be posted in the reception area/room of the medi spa and
also saved with the medical chart for seven (7) years total. After seven (7) years, client charts
may be destroyed by state law.

We hope you find your services outstanding today.
Respectfully,
Jessica Brandon, Licensed Esthetician/ Spa Owner

Injectable treatments, including neuromodulators and dermal fillers, involve medical treatments and may carry potential risks and side effects. Results vary by individual and are not guaranteed.

Common risks may include, but are not limited to, temporary redness, swelling, bruising, tenderness, headache, or asymmetry. More serious complications are rare but possible.

Injectable treatments may not be appropriate for individuals who are pregnant or breastfeeding, have certain neurological or medical conditions, active infections at the treatment site, or known allergies to treatment components.

A medical consultation and informed consent are required prior to treatment to determine candidacy and discuss potential risks, benefits, and alternatives.