Model Consent to Treatment

Date: *

Model Name: *

Model Email: *

Treatment Type: *

I consent to acting as a model for the purpose of training medical practitioners (under supervision) in the administration of botulinum toxins and/or dermal fillers. The use and indications for the products that I will be treated with have been explained to me by the practitioner and I have had the opportunity to have all my questions answered to my satisfaction. I have signed a product specific consent form. I have answered the questions regarding my medical history to the best of my knowledge. I consent to my photographs being stored on a training file.

The information that I have given is correct to the best of my knowledge: *

Yes No

I have not knowingly withheld any medical information *

Yes No

I consent to the treatment described *

Yes No

*Consent form to be signed by the model on the day of training after consultation.

Model's Signature: *

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Trainer's Signature: *

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Data Protection and Privacy

We are committed to protecting your privacy. We take special precautions with your sensitive personal data and we will process your data lawfully and as described. We only process the data we need for as long as we need to and we respect all of your rights under GDPR. We will never sell, share or otherwise abuse your data. You can contact us at any time to request your data, change your preferences or request that your data be deleted. GDPR is the European privacy law designed to protect you and give you control of your data.