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Bio Revitalisers Consent Form

Please fill out the following form
in order to participate in our activity.

Contraindications of Biorevitalisers Absolute contraindications As a matter of principle, for safety reasons, pregnant women should not have any aesthetic treatments, particularly not to the abdomen. Other contraindications include: known intolerance or allergy to any of the active substances used  highly active autoimmune processes severe cardiovascular or metabolic disorders acute viral or bacterial infections pregnancy, breast-feeding autoimmune diseases diabetes the tendency to the formation of keloids active surgical site infection cancer It is not recommended to combine injectable collagen during the same treatment session with laser treatments, deep chemical peels and dermabrasion. These procedures can be applied while maintaining the 14-day interval. Relative contraindications age below 16 years breastfeeding mothers injection phobia  herpes simplex virus (HSV1) load (preventative treatment with an antiviral agent (acyclovir or valacyclovir) is advisable) existing or suspected destruction of anatomical structures, e.g. the hair roots Mandatory Patient Precautions Before the treatment  Do not take any aspirin or enzyme products two days before the injectable collagen. Inform the therapist about any regular medication (e.g. oral anticoagulants) and previous illnesses. Inform the therapist about all allergies or intolerances (e.g. predisposition to keloids). Only cleanse the skin with water and soap, without applying any skincare products or make-up to the area being treated. Do not have any immunizations (particularly BCG) before the injectable collagen. After the treatment No full baths, saunas, massages, mudpacks or lymphatic drainage for 24 hours. Do not sunbathe for 48 hours. Do not wear any coloured, new or very tight clothing (e.g. pre-worn jeans) over the treated area. Do not use any ointments, creams or powders, unless prescribed by the physician. No X-rays/radiotherapy or electrotherapy for the next three days. Your usual skincare may be resumed after 24 hours. I confirm I have read the Information and acknowledge the contents having asked the practitioner to explain any aspects of injectable collagen that I did not understand. I understand the results vary from person to person. I acknowledge that it is impossible to list every potential risk and complication, but I have been informed of the benefits, risk and likely improvement that I will see in my skin. I have discussed my medical history with the practitioner, specifically in relation to the contraindications presented in the Information. I have disclosed all medications that I am taking or have taken within the past 60 days and have disclosed all of the topical products I am using. I understand and am willing to comply with all pre- and post-care instructions. 

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