Informed Consent Form for Facial Treatments

I, _______________ as a client, freely and voluntarily authorize the professional ____________________ of the Lipo Without Surgery aesthetic center to perform the beauty treatment (non-invasive) of ___________________________________ of which I have previously been informed in detail about its nature, procedure and possible side effects that could occur.

I declare that I have clearly and sincerely provided the data about my physical and health condition that could affect said treatment or that are contraindicated for its application or that make its performance difficult or impossible.

If at any time my health condition changes, I will inform the person in charge of carrying out the treatment so that they can take the appropriate measures.

DATA PROTECTION

“On behalf of the company Lipo Sin Cirugía we inform you that your data becomes part of a file for private use for the management and organization of our company. Processing the information you provide us in order to provide you with the requested service. The data provided will be kept as long as the commercial relationship with the client is maintained or for the years necessary to comply with legal obligations. The data will not be transferred to third parties except in cases where there is a legal obligation. You have the right to obtain confirmation as to whether at Lipo Sin Cirugía we are processing your personal data, therefore you have the right to access your personal data, rectify inaccurate data or request its deletion when the data is no longer necessary.”

I also request your authorization to offer you products and services related to those requested by you and to retain you as a customer.

Please enable JavaScript in your browser to complete this form.
Name
Select your facial treatment.
Clear Signature