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GENERAL HEALTH FORM
Dermal Filler Dissolver Consent Form
COVID Vaccination
COVID-19 Pre-Screening
B12 CONSENT FORM
DYSPORT CONSENT FORM
DYSPORT POST TREATMENT
CLIENT CONSENT FOR DERMAL FILLER-RESTYLANE
CLIENT CONSENT FOR DYSPORT COSMETIC
CLIENT CONSENT FOR DEOXYCHOLIC ACID
DERMAL FILLER POST TREATMENT
Cancellation Policy & Payment
IV VITAMIN DRIP THERAPY CONSENT
==========NOTHING HERE!!! ============
HYDRATION THERAPY
DERMAL FILLER CONSENT FORM
COVID PRE-SCREENING
COVID VACCINATION
CANCELLATION POLICY AND PAYMENT
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GENERAL HEALTH FORM
Dermal Filler Dissolver Consent Form
COVID Vaccination
COVID-19 Pre-Screening
B12 CONSENT FORM
DYSPORT CONSENT FORM
DYSPORT POST TREATMENT
CLIENT CONSENT FOR DERMAL FILLER-RESTYLANE
CLIENT CONSENT FOR DYSPORT COSMETIC
CLIENT CONSENT FOR DEOXYCHOLIC ACID
DERMAL FILLER POST TREATMENT
Cancellation Policy & Payment
IV VITAMIN DRIP THERAPY CONSENT
==========NOTHING HERE!!! ============
HYDRATION THERAPY
DERMAL FILLER CONSENT FORM
COVID PRE-SCREENING
COVID VACCINATION
CANCELLATION POLICY AND PAYMENT
COVID VACCINATION FORM
CovidVacc
FirstName
*
LastName
*
Did you receive the COVID vaccine?
Yes
No
When did you receive the first vaccination?
When did you receive the second vaccination?
Which vaccine did you receive (Pfizer or Moderna)?
Pfizer
Moderna
I acknowledge herby that I can earliest receive Botox/Dysport injections two (2) weeks AFTER the first COVID vaccination and NOT less than two (2)
weeks BEFORE second vaccination.Dermal Filler injections can be received earliest two (2) weeks AFTER the first COVID vaccination and
NOT less than two (2) weeks BEFORE second vaccination. Therefore, I am responsible to postpone my appointment for such treatment accordingly.
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Date
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