HEALTH QUESTIONNAIRE
Do you smoke?*
Do you drink Alcohol?*
Are you pregnant?*
Are you breastfeeding?*
Are you trying to lose weight?*
Are you currently taking or have you ever taken any of the following medications? (please tick all that apply)
Do you suffer from any allergies, particularly to hyaluronic acid or local anaesthetics or lidocaine?*
Do you suffer from any of the following? (please tick all that apply)
Have you ever been admitted to Hospital?*
Have you had any previous surgery (non-cosmetic)?*
Have you had any Botulinum Toxin, Dermal Fillers, Sunbed, Dermabrasion, Skin Peels or Laser Skin Resurfacing treatments in the last 6 weeks?*
Do you suffer from a bleeding disorder?*
Have you been tested positive with COVID 19?*
Have you mixed with any one who has tested positive with COVID 19 in the last 14 days?*
Have you had any of the following new symptoms in the last 7 days?* (please tick all that apply)
Have you received Coronavirus (COVID-19) vaccine?*
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