Aesthetics Consultation, Consent and Prescriber Checklist (Toxin and Dermal Fillers)

A full pre-treatment record for non-surgical cosmetic injectables – age and identity checks, medical history, psychological suitability screening, face-to-face prescriber assessment, informed consent with risks, cooling-off and a treatment record.

Editable Word document
8
10pages
Guidance notes included
aml consultancy solutions

Beauty, wellness & clinics

Aesthetics Consultation, Consent and Prescriber Checklist (Toxin and Dermal Fillers)

About this document

What it’s for

Anti-wrinkle injections (botulinum toxin) and dermal fillers carry real risks, from bruising to vascular occlusion and blindness. Botulinum toxin is a prescription-only medicine, and it is illegal to give either treatment for cosmetic purposes to anyone under 18. This record helps clinics and practitioners show they assessed suitability properly, obtained informed consent, followed prescribing rules and recorded the treatment.

When to use it

  • Before every new course of injectable treatment, and when a client’s health or medication changes
  • For both the consultation and the treatment appointment
  • With the separate Before and After Photography Consent Form

What’s inside

The document is laid out in the sections below. Each one comes with a plain-English guidance note explaining what it does and what to change.

  • Part 1 – Client details and identity
  • Part 2 – Medical history
  • Part 3 – Psychological suitability
  • Part 4 – Prescriber assessment (prescription-only medicines)
  • Part 5 – Informed consent
  • Part 6 – Treatment record

How to complete it

  • Complete Parts 1 to 3 at a consultation, before the treatment day where possible
  • The prescriber completes Part 4 after a face-to-face assessment if a prescription-only medicine is used
  • Complete the consent in Part 5 and the treatment record in Part 6 on the day

Key points to check

  • A licensing scheme for non-surgical cosmetic procedures is being introduced in England – check the latest requirements for your premises and practitioners
  • Make sure you have the right insurance and a complications protocol, with hyaluronidase available where fillers are used

Our templates are professionally structured starting points for UK businesses, not legal advice. For anything complex, unusual or high-value, have your final version checked by a solicitor.

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Editable Microsoft Word files

Guidance notes in every document

Written for UK businesses

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