Botox Consent Form Template

A handy form sample you can easily adapt to collect a brief medical history and patient consent before launching in a botox intervention.

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About this template

This botox consent form is designed for clinics and practices providing botox (botulinum toxin) treatments when they need to collect legally binding consent signatures and medical information from their patients before moving on with the procedures. Simplify the process and get rid of paper forms while staying legal and making sure you provide your patients with a clean, organzied experience. Get this botox consent form template now, customize it to your needs and your practice using our form builder, and share it with patients via email before you proceed with the botox treatment.

Frequently Asked Questions

The easiest way to create a botox consent form is by getting this botox consent form template, personalizing it to your needs (by dragging & dropping fields and editing text), and then publishing it wherever you want.

A botox consent form should include the name and contact details of the patient, their medical history, whether they are a parent or lactating, whether they are on specific medication or have previous surgeries, as well as how they will pay for the procedure; and, of course, their signature.

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