**MEDICAL POST-PROCEDURE CARE, CONSENT,

ASSUMPTION OF RISK & LIABILITY WAIVER**

This document constitutes a legally binding medical agreement between Botox On The Go Ltd (“the Clinic”) and the Patient named below.

By signing this document, the Patient confirms full understanding, acceptance, and agreement to all terms contained herein.

PATIENT IDENTIFICATION

Full Legal Name: __________________________________________
Date of Birth: ___________________________________________
Home Address: ___________________________________________

Telephone: ______________________________________________
Email: _________________________________________________

TREATMENT(S) RECEIVED (Tick all that apply)

☐ Microneedling
☐ Salmon DNA / PN / PN-H
☐ CO₂ Laser
☐ Injectable Treatments
☐ Surgical / Advanced Aesthetic Procedures
☐ Other (Specify): __________________________________________

ACKNOWLEDGEMENT OF MEDICAL RISK

The Patient acknowledges that all aesthetic, laser, regenerative, and surgical procedures carry inherent and unpredictable risks, including but not limited to infection, scarring, pigmentation changes, delayed healing, allergic reaction, and unsatisfactory outcomes.

Results are not guaranteed.

MANDATORY POST-PROCEDURE INSTRUCTIONS

The Patient confirms that verbal and written aftercare instructions were provided before and/or on the day of treatment and must be followed strictly, precisely, and without deviation.

GENERAL POST-CARE – ALL PROCEDURES

The Patient agrees to:

• Not touch, rub, scratch, massage, or apply pressure to treated areas

• Keep treated areas clean and dry

• Avoid make-up, active skincare, retinoids, acids, vitamin C, exfoliants

• Avoid sun exposure, UV devices, heat, saunas, steam rooms, swimming pools

• Avoid alcohol, excessive sweating, and strenuous exercise

• Use only products prescribed or authorised by the Clinic

• Refrain from self-medicating or applying any topical or oral treatment without approval

MICRONEEDLING & SALMON DNA (PN / PN-H)

The Patient understands that redness, swelling, tenderness, and sensitivity are expected and agrees to:

• Avoid make-up for 24–48 hours

• Avoid heat, alcohol, and exercise for 24–48 hours

• Follow the prescribed skincare protocol exactly

CO₂ LASER & SURGICAL PROCEDURES – CRITICAL WARNINGS

ANY FAILURE TO COMPLY WITH THE FOLLOWING IMMEDIATELY TERMINATES CLINIC LIABILITY.

The Patient agrees:

• NOT TO COVER THE TREATED AREA WITH CLING FILM OR OCCLUSIVE DRESSINGS unless expressly instructed in writing by the Clinic

• The POST OP is clear and simple - Savln (Burns cream on the next 1-2 days ) do not cover - AVOID WATER - after area is dry you can wash with lukewarm water and apply Laroche cucaplast

• No antibiotics is required as we need this controlled inflammatory process

• NOT TO BATHE, SHOWER, OR ALLOW WATER CONTACT with the treated area unless specifically authorised

• Not to pick, peel, scratch, or forcibly remove scabs or crusting

• Not to apply unauthorised products or medications

• To strictly avoid sun exposure

NO INDEPENDENT DECISION-MAKING

The Patient agrees:

• Not to deviate from any instruction provided

• Not to rely on third-party advice (including internet, social media, or non-clinic professionals)

• To contact Botox On The Go immediately before taking any action outside the provided guidelines

Failure to do so transfers full responsibility to the Patient.

FULL WAIVER & LIMITATION OF LIABILITY

To the maximum extent permitted by UK law, the Patient irrevocably waives and releases Botox On The Go Ltd, its practitioners, directors, employees, and affiliates from any and all liability, claims, damages, or losses arising from:

• Failure to follow post-procedure instructions

• Patient-initiated aftercare decisions

• Use of unauthorised products, medications, or treatments

• Exposure to heat, water, sun, pressure, or occlusion against advice

• Any action taken without prior Clinic approval specially going to Hospital prior to talking to DR Carlos

All resulting complications are the sole responsibility of the Patient.

INSURANCE, INVESTIGATION & MEDICAL REVIEW

The Patient understands and agrees that in the event of a complaint, adverse outcome, or insurance claim:

• All medical records will be disclosed and reviewed

• The Clinic premises are monitored by CCTV

• All consent forms and documentation will be examined

• A third-party independent medical professional will review the case

• Toxicology testing may be requested or required

If any steps were omitted or contradicted from documentation discussed before or on the day of treatment, no liability will attach to the Clinic.

FINAL PATIENT DECLARATION

By signing below, I confirm that:

• I have read and understood this document in full

• I had the opportunity to ask questions

• I accept all medical risks

• I agree to follow all instructions without deviation

• I understand this document is legally binding

PATIENT SIGNATURE

Printed Name: __________________________________________
Signature: _____________________________________________
Date: _________________________________________________

CLINIC REPRESENTATIVE

Practitioner Name: _____________________________________
Signature: _____________________________________________
Date: _________________________________________________