Currently pregnant or breastfeeding

Known allergies (medications, latex, antiseptics)

Diabetes

Autoimmune disease

Blood disorders / clotting issues

Skin conditions

(eczema, psoriasis, dermatitis)

Heart conditions

Current infection or illness

High blood pressure

Seizures

Asthma

Migraines

Epilepsy

Allergy to Lidocaine or local anaesthetics

Previous adverse reaction to injectables

Blood-thinning medication (aspirin, warfarin, etc.)

Active cold sores / herpes simplex

Recent dental work (last 2 weeks)

Immune-suppressing medication

Previous filler complications

I confirm I have no known allergy to lidocaine or topical anaesthetics

I understand anaesthetic products may cause rare allergic reactions

Bruising, swelling, redness

Infection

Asymmetry

Vascular occlusion (rare)

Vascular occlusion (rare)

Temporary or permanent complications

I confirm that the information provided is accurate

I consent to images/videos being taken for medical records.

I consent to anonymized marketing use of images/videos

I consent to treatment following consultation