AMEELA POLYNUCLEOTIDES CONSENT FORM

AMEELA POLYNUCLEOTIDES CONSENT Form

To the patient:

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A copy of this form is avaliable to you, please ask. Your consent and authorization to receive the treatment are totally voluntary. The nature of this procedure, the alternative methods possible as well as the complications were all explained to you. No guarantee of results has been promised to you.
I accept the clinic terms and conditions. I am satisfied treatment with dermal fillers has been explained comprehensively and that the possible risks and side effects associated with the treatment have been fully discussed and understood. I have taken sufficient time to process and consider the information provided and any questions I had have been answered to my satisfaction, before making a decision to proceed with the agreed treatment plan.

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