Build a digital dermal filler consent form with the help of WaiverElectronic system.

INFORMED CONSENT - DERMAL FILLERS

- I consent that I consent to receiving treatment using hyaluronic acid filler

- I have been given sufficient information to enable me to understand the product, procedure, risks and side effects

- I understand there is a risk of possible: bruising, bleeding, redness, swelling, lumpiness, reactivation of herpes, pain and discomfort

- I understand the possible risks with all injectables treatment including: risk of infection, severe bleeding, vessel occlusion with potential lip necrosis, granuloma, haematoma, abscess formation and hypertensive or an allergic reaction

- I agree to the use of a topical anaesthetic cream

- I agree to the post treatment advice given to me by the practitioner

-I understand that the practice of medicine and surgery is not an exact science and therefore no guarantee can be given as to the results of the treatment referred to in this document. I accept and understand the goal of this treatment is improvement, not perfection and there is no guarantee that the anticipated results will be achieved.

- I understand no procedure is risk free

- I have had the procedure, risks, possible side effects explained to me

- I have had the chance to ask my practitioner any questions

- I understand fillers can have rare but serious complications that may require the opinion of a plastic surgeon for which Belle Aesthetics Leeds will not be liable for

- I consent I have provided honest and truthful information to my practitioner

- I understand the treatment is non refundable

-I consent for the use of photography and accept my photos may be used for Belle Aesthetics marketing and social media

- I am aware of the Belle Aesthetics Leeds privacy policy and understand that personal information may be passed onto a third party when necessary