Consent for Aesthetic Treatments by Dr Svetlana Lakunina.

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* 1. Name

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* 2. What is your date of birth?

By submitting this form, I confirm that my health history is accurate and complete, I understand the side effects and possible complications related to my treatment, and I agree with the policy.
Please Note: due to subjective nature of the treatment, it is not possible to guarantee results; longevity of the treatment results may vary between individuals; patients can react differently to the same treatment; list of possible complications is not exhaustive.

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* 3. Your medical history / pregnancy status / allergies / previous aesthetic treatments/ current medications.

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* 4. I consent to this activity/procedure.

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* 5. Enter date

Date

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About Anti-Wrinkles Injections.

About Anti-Wrinkles Injections.

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About Anti-Wrinkles injections.

About Anti-Wrinkles injections.

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About Dermal Fillers.

About Dermal Fillers.

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About Dermal Fillers.

About Dermal Fillers.

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