Clinic – F9 x Solta

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Dear Sir or Madam,

This letter agreement (the agreement) confirms the terms on which I agree to allow,(i) Solta Medical Ireland Limited, a Bausch Health company, with a place of business at 3013 Lake Drive, Citywest Business Campus, Dublin 24, Ireland, and its affiliates (together the Companies) to use, Clinic’s name, logo, and/or practice contact details of

Clinic Name:

for the purposes set out below.

the CLINIC hereby grants to each of the Companies the express right to use the name of the CLINIC, the contact details of the CLINIC (main contact person, address, telephone, e-mail and/or website) and/or the logo of the CLINIC as listed in the Annex (hereinafter "DATA") on the following websites of each of the Companies in connection with Solta Medical's products (hereinafter "Websites"):

www.soltamedical.com

www.fraxel.de

www.thermage.de

www.clearandbrilliant.de

www.dearandbrilllant.com

www.vaser.com

www.reaffirmage.it

www.soltamedical.co.uk

www.fraxel.co.uk

www.thermage.co.uk

www.clearandbrilliant.co.uk

www.clearandbrilliant.es

www.clearandbrilliant.fr

www.clearandbrilliant.it

www.clearandbrilliant.ch

www.clearandbrilliant.at

www.vaser.at

www.myvaser.com

The DATA on the Websites is used solely to identify the CLINIC as a customer of the Companies and as the practice/clinic where Solta Medical's products are available. Except as expressly provided herein, neither CLINIC nor the Companies may use each other's names or trademarks without the other's prior written permission.

Each of the company will:
1. Comply with the requirements of all applicable laws and regulations with respect to the use of theDATA and any related personal data; and
2. Process the DATA and any related personal data in accordance with the Privacy Statements on theWebsites, available at https://www.bauschhealth.com/privacy-policy, as amended from time to time.

Any of the Companies shall have the right to assign this Declaration by merger, acquisition, partnership, license agreement, assignment agreement or otherwise to any third party or affiliate or successor in interest.

This declaration of consent can be revoked at any time with effect for the future at infoEMEA@solta.com . In case of revocation, the DATA will be removed from the relevant website. If the DATA were available on the Internet, the removal takes place as far as it is subject to the disposal possibilities of the company.

All Vaser surgeons in the United Kingdom and Ireland must be a member of one of the four Royal College of Surgeons (London, Edinburgh and Glasgow) and Ireland (Dublin) to be eligible to be entered in the clinic finder

This Declaration and any dispute or claim (including non-contractual disputes or claims) arising out of or in connection with it or its subject matter shall be governed by and construed in accordance with the laws of Ireland.

The courts of Ireland shall have exclusive jurisdiction to settle any dispute or claim (including any non-contractual disputes or claims) arising out of or in connection with this Declaration or its subject matter or formation

Name [NAME OF THE Managing Director]*

Signature*

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Name of the Clinic's Contact Person:

Name of the Doctor:

Phone Number of the Clinic:

Email Address of the Clinic:

Opening Hours

Clinic Description

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Website Clinic:

Logo Clinic:

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If not uploaded, the logo will be taken from the website.

Thermage® FLX

Fraxel® DUAL (former Fraxel re:store DUAL)

Clear + Brilliant®

VASER®:

Thermage® FLX Serial No.:

Fraxel® DUAL (former Fraxel re:store DUAL)Serial No.:

Clear + Brilliant® Serial No.:

VASER® Serial No.:

Phone

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