prescription consultation
Important Information - Please Read Before Completing
You are being asked to complete this medical questionnaire prior to a face-to-face consultation with the prescribing practioner who will authorise your treatment. The medication will be administered by your chosen aesthetics practioner under the supervision of the prescriber. The information you provide is essential to assess your suitability for botulinum toxin treatment, determine the safest and most effective dosage and ensure that the treatment is appropriate for your individual needs. All details you provide will be treated as strictly confidential and used only for the purpose of your clinical assessment.