BOTOX Name *Last Name *Date of birth *Age *Gender *Choose genderFemaleMalePhone *E-mail address *Address *City *State *Zip/Postal Code *Emergency Contact *Emergency Phone *How did you hear about Beauty Esthetics? *INFORMED CONSENTI declare that Dr. Roynny Javier Sánchez Gil has provided me with information about botulinum toxin. The aim of the technique is the selective and temporary reduction of the contraction in the hyperactive musculature, ranging from 4-6 months, by means of the action of the toxin on the peripheral nerve endings. The performance of the procedure can be recorded for didactic and scientific purposes. The procedure is usually performed without anesthesia. The treatment consists in the injection with small needles of the toxin in the areas where its effect is intended. Despite the correct technique, there may be adverse effects such as: headache, pain in the injected area, swelling, facial asymmetry, redness, hematoma, although these are rare. I have also been informed that for best results a touch-up may be necessary after 10 to 15 days. I have been informed about the care to be taken after the placement of the toxin (Do not massage the injected area, do not drink alcohol or do physical exercise for the first 24 hours, do not lower your head or lie down for the first 4 hours, do not expose yourself to the sun for the first 24 hours). I HAVE UNDERSTOOD THE INFORMATION GIVEN TO ME, I DECLARE THAT I AM SATISFIED WITH IT AND I UNDERSTAND THE SCOPE AND RISKS OF THE TREATMENT, UNDER SUCH CONDITIONS.Medical Consent *I agree to undergo the BOTULINUM TOXIN TREATMENT at Beauty Esthetics. I agree with theprivacy policy and general conditions.PHOTO AND VIDEO AUTHORIZATION FORMI would like your permission to use these photos for advertising purposes. For example: portfolios, online and print ads, etc. Your consent is required in this regard. Please circle and indicate with your signature whether or not you would like your photos to be used in advertising. We also like to tag our clients in the photos used in our Social Networks! Please indicate whether you wish to allow this or not. Below,You can use them for the RRSS *SelectYESNOTag me on RRSS *SelectYESNOInstagram user *Send
