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What is an example of Botox consent?

I understand this is an elective procedure and I hereby voluntarily consent to treatment with botulinum toxin injections for facial dynamic wrinkles, TMJ dysfunction, bruxism and types of orofacial pain including headaches and migraines. The procedure has been fully explained to me.

What are the long term side effects of Juvederm?

The only real long term effects of Juvederm come down to those who scar, have a long lasting inflammatory response, or filler fatigue. Scarring after injections of any kind is rare. However, if done improperly, injured following the injection, or a complication occurs, scarring can happen.

Who should not use Juvederm?

JUVEDERM is contraindicated for patients with severe allergies manifested by a history of anaphylaxis or history or presence of multiple severe allergies. JUVEDERM contains trace amounts of gram positive bacterial proteins and is contraindicated for patients with a history of allergies to such material.

dermal filler consent form pdf

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Is there such thing as a consent form?

A consent form is a legal document that ensures an ongoing communication process between you and your health care provider.

What are the warnings for Juvederm?

JUVEDERM is contraindicated for patients with severe allergies manifested by a history of anaphylaxis or history or presence of multiple severe allergies. JUVEDERM contains trace amounts of gram positive bacterial proteins and is contraindicated for patients with a history of allergies to such material.

Can Juvederm go wrong?

When injected, these substances can cause allergic reactions, infections, and the death of skin cells. Another risk is that improper injection technique can lead not only to swelling and lumpiness, but also more serious side effects such as death of skin cells, and embolism leading to blindness.

What should be included in an informed consent form?

The consent form must include: A statement that the study involves research. Purpose of the research. Procedures. Risks or discomforts to the subject. Benefits of the research to the subject. Treatment Alternatives. Costs of Participation. Confidentiality.

What are the problems with Juvederm fillers?

Side effects reported in clinical trials include facial weakness, eyelid drooping, and brow drooping. Other adverse events included localized pain, swelling, reddening, and bruising at the injection site. In rare cases, injections have resulted in double vision, dry eyes, or difficulty swallowing or breathing.

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