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As part of your Cosmetic Treatment program, we will be photographing the treatment area of your body/face (and in some cases, filming) the treatment process. This will allow us to visually monitor your individual progress and see the results of your treatment over time.
We would appreciate your willingness to share your outcomes and results with others, for both training and marketing purposes within the beauty, cosmetic and aesthetic industries.
We will use absolute confidentiality regarding your identity when using your pictures. To confirm acceptance of this agreement, kindly sign the consent form below.
Also, we would be grateful if you could provide a comment as to how you felt about using the proposed treatment program and the results achieved in the space below.

 I  consent to my  Before and After images from the treatment program being used for publicity through the media or promotions. I understand you will use absolute discretion with respect to my identity. 


With this consent, I give permission for the images/footage (if they are selected) to be used in the following and similar materials:


(Please tick one or both preferences)



I, the undersigned, give my full consent for all photographs/footage captured before, during and after my treatment program, allowing these images to remain the property of and be used by our clinic representatives and hereby agree that my photograph and/or video image may be used as described above.












Thanks for submitting!
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