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Client Form 02

Treatment Consent

Treatment consent is considered separately from marketing consent and should be completed only after the proposed treatment has been discussed.

Client & Treatment

Full name Date

Treatment being considered

Consent Statements I have had the opportunity to discuss the proposed treatment and ask questions. I understand that treatment outcomes vary and no specific result can be guaranteed. I understand that aesthetic procedures can involve risks, side effects and complications. I understand that treatment may be declined, postponed or changed where it is not considered appropriate. I confirm that I have disclosed relevant medical information, medication, allergies and previous aesthetic treatment. I understand any aftercare advice provided should be followed. I understand that further treatment, review or corrective treatment is not automatically included unless specifically agreed. I understand I may withdraw my consent before treatment begins.

Questions or Additional Notes Anything you would like clarified before treatment?

Terms & Privacy I confirm that the information I have provided is accurate to the best of my knowledge. I have read the Terms & Conditions and Privacy Policy.

This website version does not transmit medical information yet. The form will be connected to a secure submission system before launch.

FALLEN SKIN & AESTHETICS

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Treatment suitability and outcomes vary between individuals. A consultation and assessment may be required before treatment.