What if we told you there is absolutely no reason you have to put up with underarm sweat? It’s a radical concept, but it’s true. You were born with approximately 2 million sweat glands throughout your body, and your underarms only contain about 2% of those glands.¹ Eliminating that 2% does not affect your body’s ability to cool itself.

The Truth About Sweat What Is miraDry?The miraDry System is the only U.S. Food and Drug Administration-cleared treatment that can dramatically reduce underarm sweat by addressing the root cause of excessive sweat – not the symptoms.

How It Works

Permanent Immediate Non-surgical

Around 1 in 10 people around the world suffer from excessive sweat.2,3

You’re Not Alone

Once those glands are eliminated, they do not grow back.

miraDry uses thermal energy that targets and eliminates the sweat glands in your underarms.

The treatment is typically complete in one hour, and you should see results in as little as one treatment.4 However, as with any medical procedure, your physician will determine the best protocol for your desired results.

82%CLINICALLY PROVEN SWEAT REDUCTION5

90% ALL-TIME "WORTH IT"

RATING BY REALSELF.COM6

SWEAT LESS.LIVE MORE.Permanently reduce underarm sweat.

Visit miraDry.com for more information, including:

Want to Know More?

Real patient stories

Science behind miraDry

What to expect during treatment

Is Sweat Stressing You Out?

Why stress over underarm sweat if you don’t have to? Ask for a consultation today.

If you answered yes to any of the questions above, miraDry offers a safe, convenient, and permanent solution to underarm sweat.

Are you annoyed or embarrassed by underarm sweat?

Are you sick of yellow underarm stains or antiperspirant marks on your shirts?

Are you avoiding social activities because you’re anxious about how much you may sweat?

Are you seeking a natural, toxin-free lifestyle?

Are you just tired of worrying about underarm sweat at all?

References: 1. Taylor NAS, Machado-Moreira CA. Regional variations in transepidermal water loss, eccrine sweat gland density, sweat secretion rates and electrolyte composition in resting and exercising humans. Extrem Physiol Med. 2013;2:4. 2. Data on file. 3. Data on file. 4. Lupin M, Hong HC, O’Shaughnessy KF. Long-term efficacy and quality of life assessment for treatment of axillary hyperhidrosis with a microwave device. Dermatol Surg. 2014;40(7):805-807. 5. Hong HC, Lupin M, and O’Shaughnessy KF. Clinical evaluation of a microwave device for treating axillary hyperhidrosis. Dermatol Surg. 2012;38(5):728-735. 6. RealSelf miraDry “Worth It” ratings over all time, sourced September 26, 2018. Patient results and experience may vary. The miraDry System is Food and Drug Administration-cleared in the U.S. for the treatment of unwanted underarm sweat and odour, as well as the permanent removal of unwanted underarm hair. Outside the U.S., the miraDry System is intended for use by health care professionals for treatment of primary axillary hyperhidrosis in adults. miraDry® and No Sweat No Stress™ are trademarks of miraDry, Inc. © 2019 miraDry, Inc. All rights reserved.MK0777.A-ENG.A

Mater Medical SuitesSuite 9, Level 3, 25 Fulham RdPimlico, QLD, 4812

(07) 4795 2123

Dr. Amit Nigam

www.sweatclinic.com.au

Nephrologist (Renal) & General Physician

NIGAM

1. Li et al. Antigen expression of human eccrine sweat glands. J Cutan Pathol 36: 318-324 (2009). Lupin et al. Long-term efficacy and quality of life assessment for treatment of axillary hyperhidrosis with a microwave device. Dermatol Surg 40: 805-807 (2014). 2. Data on file. miraDry, Inc.

Patient results and experience may vary. The miraDry system is FDA-cleared for the treatment of unwanted underarm sweat and odor, as well as the permanent removal of unwanted underarm hair. Outside the U.S., the miraDry system is intended for use by health care professionals for treatment of primary axillary hyperhidrosis in adults. © 2018 miraDry, Inc. All rights reserved. MK0052.K

PATIENT DETAILS FORM Title: _________ First Name: _____________________________ Middle Name: ______________________________ Surname: ______________________________

Known As: ___________________________________________ DOB: ______________________________________ Gender: Female / Male ___________________

Residential Address: ___________________________________________________________ Suburb: __________________________ Postcode: ________________

Postal Address: _______________________________________________________________ Suburb: __________________________ Postcode: ________________

Phone: ______________________________________________ Mobile: ___________________________________________________________________________

Email address: ________________________________________________________________ Skype address: _____________________________________________ (for future telehealth appointments, if eligible at doctor discretion only) *Do you consent to receive appointment reminders via SMS? Yes No *Do you consent to being contacted by email? Yes No

Next of Kin / Emergency Contact Details

Next of Kin Name: _______________________________________________________________________________________________________________________

Relationship: _________________________________________ Contact Phone Number: _____________________________________________________________

* I provide consent for messages to be left with immediate family members/defacto partners (eg. appointment confirmation). Yes No * I provide consent for staff to disclose information to my Next of Kin should they call on my behalf. Yes No

Medicare / Private Health / DVA

Medicare Number: ____________________________________________________________ Patient No: ________________ Exp. Date: ______________________

Health Fund: _________________________________________________________________ Policy/Member No.: _________________________________________

Concession/Pension Number: ____________________________________________________ Expiry Date: ________________________________________________

DVA Number: _________________________________ Colour: Gold / White – Conditions: ________________________________________________________

Defence EP ID / PMK’s: _________________________________________ Defence Approval Number: ___________________________________________________ Referring Doctor / GP Details

Referring Doctor: _________________________________________________ Practice: _______________________________________________________________

Regular GP: _____________________________________________________ Practice: _______________________________________________________________ CONSENT TO COLLECT PATIENT INFORMATION This medical practice collects information from you for the primary purpose of providing quality health care. We require you to provide us with your personal details and medical history so that we may properly assess, diagnose, treat and be proactive in your health care needs. We will use the information you provide in the following ways: 1. Administrative purposes in running our medical practice. 2. Billing purposes, including compliance with Medicare and Health Insurance Commission requirements. 3. To obtain relevant medical information from previous treating doctors, specialists & service providers outside this medical practice. 4. For disclosure to others involved in your health care, including treating doctors, specialists and health services providers outside this medical practice. (eg: referral to other specialists, pathology

and x-ray services and reports back to doctors involved in your care). - I understand the reasons why my information must be collected and provide my consent for the doctors and staff at this practice to collect, use and disclose my personal information as outlined in the

privacy information and above. - I understand that I am not obliged to provide any information requested of me, but that my failure to do so might compromise the quality of the health care and treatment given to me. - I provide consent for my information to be obtained from my referring Doctor and others involved in my health care by Fax, Mail and Email. - I provide consent for my information to be disclosed to my referring Doctor and others involved in my health care by Fax, Mail and Email. - I understand that I am entitled to access my own health records except where access would be denied as outlined in the privacy information. - I understand that I may withdraw my consent as to the use and disclosure of my personal information (except when legal obligations must be met). I understand my withdrawal of consent must be in

writing.

By signing below, I acknowledge that I have read and understand the above information. I provide consent for my information to be collected, used and disclosed as outlined above and on the privacy information sheet. Patient Name: ___________________________________________________ Parent/Guardian: ________________________________________________________ (please print) (If applicable) Signature: _______________________________________________________ Date: _________________________________________________________________

CLINICAL INFORMATION

1. Li et al. Antigen expression of human eccrine sweat glands. J Cutan Pathol 36: 318-324 (2009). Lupin et al. Long-term efficacy and quality of life assessment for treatment of axillary hyperhidrosis with a microwave device. Dermatol Surg 40: 805-807 (2014). 2. Data on file. miraDry, Inc.

Patient results and experience may vary. The miraDry system is FDA-cleared for the treatment of unwanted underarm sweat and odor, as well as the permanent removal of unwanted underarm hair. Outside the U.S., the miraDry system is intended for use by health care professionals for treatment of primary axillary hyperhidrosis in adults. © 2018 miraDry, Inc. All rights reserved. MK0052.K

How Did You Hear About Us: GP , Google , Facebook/Instagram , Newspaper , Other ……………………….. What was your first point of contact: GP , Phone call to us , Email , Other ……………………….. Name of first contact:………………………………….. Hyperhidrosis (Excessive Sweating) Area Affected: Underarms , Head/Face , Hands , Feet , Other ……………………….. Medical History

Year

Current Medications (Including over the counter) Dose

Allergies Reaction

Lignocaine use in past e.g. dental treatments No Yes:

Height (cm): ________________ Weight (kgs): ________________

Current Occupation: _____________________________________________________________________________________________________________________

Smoking: Never Social Yes – per day: _________________ Quit: _______________ (year)

Alcohol: Never Less than 14 standard drinks per week More than 14 standard drinks per week

1. Li et al. Antigen expression of human eccrine sweat glands. J Cutan Pathol 36: 318-324 (2009). Lupin et al. Long-term efficacy and quality of life assessment for treatment of axillary hyperhidrosis with a microwave device. Dermatol Surg 40: 805-807 (2014). 2. Data on file. miraDry, Inc.

Patient results and experience may vary. The miraDry system is FDA-cleared for the treatment of unwanted underarm sweat and odor, as well as the permanent removal of unwanted underarm hair. Outside the U.S., the miraDry system is intended for use by health care professionals for treatment of primary axillary hyperhidrosis in adults. © 2018 miraDry, Inc. All rights reserved. MK0052.K

DO YOU CURRENTLY HAVE ANY OF THE FOLLOWING CONDITIONS: » heart pacemakers and other electronic device implants…………………………….…………….………..………………YES / NO » in need of supplemental oxygen………………………………………………..………………………….……………………………YES / NO » known history of intolerance of local anesthesia, including lidocaine and epinephrine………………………YES / NO » pregnancy………………………………………………..………………………………………………..…….……….….……………………YES / NO » underlying skin conditions………………………………………………..…………………………….………………..………………..YES / NO » previous axillary surgery………………………………………………..……………………………….…………….…….……………..YES / NO

Print Name: _______________________ Signature: _______________________ Date: ________________

Physician: __________________________ Signature: _______________________ Date: ________________

Practice Name: North Queensland Sweat Clinic