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Consent Form for Botulinum Toxin Type A

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  • I confirm that I consent to receiving treatment using Botulinum Toxin Type A.
  • I have been given sufficient information to enable me to understand the product.
  • I understand there is a risk of possible: Bruising, bleeding, redness, swelling and discomfort and more rare: headaches, drooping eye lid, localised muscle weakness and face pain.
  • I understand more rare side effects can be: infection, anxiety, numbness, dizziness, inflammation of the eyelid, eye pain, visual disturbance and nerve damage.
  • I understand the possible risks with Botulinum Toxin Type A.
  • I agree to the post treatment advice given by my 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 Botulinum Toxin Type A can have rare complications that may require an opinion of a plastic surgeon or neurologist for which Be You Aesthetics Leeds Limited 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 agree that after treatment I will avoid alcohol consumption, strenuous physical activity for 6 hours post treatment
  • I understand I cannot lay down for 4 hours post treatment.
  • I consent to the use of photography and understand my photos may be used for marketing and social media.
  • I am aware of the Be You Aesthetics Leeds Privacy Policy and understand that personal information may be passed onto a third party when necessary.

I understand this procedure and I hereby consent to treatment with Botulinum Toxin Type A. The procedure has been fully explained to me and I understand in the rare event of a serious complication I will be liable to seek professional opinion of a plastic surgeon or neurologist which will not be covered by Be You Aesthetics Leeds

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IMPORTANT INFORMATION FOLLOWING BOTULINUM TOXIN TYPE A TREATMENT

  • Do not bend excessively or lay flat for at least 4 hours
  • Do not exercise for 24 hours
  • Avoid saunas, sunbeds, steam rooms, facials, skin peels etc for 2 weeks post procedure
  • You will not see the full effect of Botulinum Toxin Type A until 2 weeks – if a top up is required please contact us around day 12
  • Top ups increase the chance of resistance against the toxin so we only advise this if absolutely necessary

Finally, treatment with Botulinum Toxin is temporary and to maintain the effects, treatment is recommended every 3 to 6 months. Doing so, acts as a preventative for fine lines and wrinkles.

Do not hesitate to contact our medical team on -01134501646/07894855334 should you have any queries.

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