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CONSULTATION FORM

Please click this link below to read ALL information about Botox before completing this form. 

It will state the reasons why you cannot have the treatment, Pre treatment advice and Aftercare.

ANTI WRINKLE CONSULTATION FORM

Please select a date you'd like

our Prescriber to Facetime you.

BEFORE TREATMENT APT

Please select the times below suitable for your Facetime from our Prescriber on the date you have selected.

Have you had Botox before?
What area's are you being treated for?

MEDICAL INFORMATION

1) Do you, or have you suffered from any Neo Muscular Issues?
2) Are you on any BP/Cardiac Medications?
3) Are you Pregnant?
3) Are you Breastfeeding?
4) Have you ever suffered from an Anaphylatic Reaction?
6) Are you currently seeing a Doctor or Clinic?
7) Do you carry a warning card?
8) Are you taking any medications or suppliments?
9) Do you Bleed/Bruise easily?
10) Are you receiving Treatment for any medical condition? or have you in the past?
11) Do you suffer from Haemophilia?
14) Have you had any sugery recently?
15) Are you undergoing any Dental Procedures?
16) Do you Suffer from Herpes Simplex? (Cold Sores)
17) Do you suffer from Keloid or Hypertrophic Scarring?
18) Do you suffer with Rosacea?
19) In the last 6 weeks have you undergone any Chemical, Mechanical or Laser Resurfacing?
20) Do you suspect or have you been diagnosed with HIV or AIDS?
21) Do you suffer from any Skin Conditions?
22) Are you on holiday within the next 2 weeks?
23) Have you ever had any cosmetic Injectables?
24) Do you suffer from Hepatitis
By submitting this form, you declare you have answered all the questions above truthfully and to the best of your knowledge. You are also agreeing to inform The Beauty Spot of any changes to your Medical information, Medications/Surgeries etc before each appointment.
 
By Submitting this form you are also understanding the terms for the 2 week review period. You understand that if you fail to see The Beauty Spot 14 days/2 weeks AFTER your treatment and sill wish for an appointment for corrections/top up that you will be charged FULL TREATMENT PRICE.
By signing this form you also accept that you have read, fully taken in and understood all the terms, knowledge and side affects that Botox may have.  

This Anti Wrinkle treatment works by freezing those muscles which contract to create those unwanted lines and wrinkles. Once you have had the treatment you will see results within the following 10 -14 days. It is not instant.

With Botox, we aim to freeze about 60% Movement, we never want to freeze more then this as this is where complications can start to arise. 

After the Treatment you may experience  slight redness around the injected area and some bumps may also appear where the Botox has been injected. The Bumps tend to go around quite quickly between 10-30 minutes after the Treatment. The redness some people may find can stay for around 12 hours after Treatment.

On quite delicate/sensitive skin, especially around the Eye area (Crows Feet) that bruising may occur. This bruising will go down in time and The Beauty Spot will do everything we can to avoid this happening.

Some people may also have side affects such as :

  • Headaches for a few days after treatment

  • Slightly Bruising/Bumps

  • Flu like symptoms for first 24 hours after

  • Eyelid, Brow dropping. (We obviously try to avoid this from happening, this is why we like to see you at your 2 week review as we never over inject at your first treatment, we play it safe and responsible.)

There are also some rare side affects that can come along with this treatment, which you need to understand before getting done. which are Double Vision/Blurred Vision, Shortness of breath or difficulty breathing. If any of these occur you need to contact for medical help asap by calling 999. Although as we stated these are rare side affects We do have to make you known of these.

Everyone is different with how frequently they have to come back and have this treatment again, Majority will find it lasts anywhere between 12-16 weeks. Whereas you might get some other people that can get much longer out of this Treatment. It is all about how quickly your body breaks down the treatment. ​

BEFORE YOU HAVE THE TREATMENT PLEASE ENSURE YOU DO NOT COME ON AN EMPTY STOMACH.

 

Thanks for submitting your form!

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