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Botulinum Toxin (Botox) Consent Form

A botulinum toxin consent form template, written by a UK aesthetic physician, designed to stand up to scrutiny. If a patient complains, your consent form is the document that protects you. Generic templates don’t.

£14 Single-clinic licence · Instant download
Available now
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UK Consumer Contracts Regulations 2013 apply — digital downloads non-refundable once delivered.

Botulinum Toxin (Botox) Consent Form — substrate cover page
£14 Botulinum Toxin (Botox)
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What's inside

The 4-file bundle.

01

Branded interactive PDF

For iPad and tablet workflows. Patient details, tick-boxes, initials boxes, and signature pads are all fillable on screen. Patients sign with a finger, Apple Pencil, or stylus.

02

Branded editable Word document

For clinics that prefer print, customise, and sign on paper. Find-and-replace targets are highlighted throughout — three minutes from download to deployable.

03

Plain clinical content (Word)

Clean clinical text, no branding or signature blocks. Drop directly into Pabau, Jotform, Faces, Aesthetic Nurse Software, or any digital consent platform.

04

Instructions PDF (2 pages)

Explains which file is for which workflow, the find-and-replace process, and how to deploy each variant.

What's covered

Clinical scope.

  • Upper face — frontalis (forehead lines), glabella (frown lines / "11s"), crow’s feet, brow shape and elevation
  • Lower face and neck — bunny lines, perioral lines, gummy smile, lip flip, downturned mouth corners, dimpled chin, masseter (bruxism and jawline contouring), platysmal bands and the Nefertiti lift

Product brands

Botox® (AbbVie), Azzalure® (Galderma), Bocouture® (Merz), Nuceiva® (Evolus). Brand non-interchangeability declared.

The detail

Why this isn't a £5 Canva template.

Risks written as headed clinical paragraphs with frequency labelling (common / uncommon / rare / serious / very rare). The way risk should actually be documented under Montgomery v Lanarkshire — not bullet points.

Off-label use declared explicitly. Brand-versus-brand non-interchangeability stated. Product disclosure built in.

Initialling box at the end of every section — the medico-legal gold standard for demonstrating section-by-section comprehension.

Cancellation, refund, and finance language already structured.

Footer makes the clinical and licensing position explicit: single-clinic use, not a substitute for local medico-legal review.

Single-clinic licence and single-author authority. No 200 other clinics in your area downloading the same form.

FAQ

Common questions.

Can I edit it?
Yes. The branded Word doc is fully editable. All clinic-specific placeholders are highlighted as find-and-replace targets — three minutes from download to deployable.
Will it work with Pabau, Jotform, Faces or ANS?
Yes. The plain content Word doc is built specifically for paste-into-platform workflows. Real heading styles, no logo, no signature blocks — the platform handles those natively.
Do I have to credit Cleritas?
No. The footer credit line is licence-required, but you can present the form to patients as your clinic’s document. That’s the whole point.
What if I run multiple clinics?
Get in touch before purchase. Multi-site and group licences are available at standard tiers. Single-clinic licence covers one trading location only.
Is it MHRA / GMC / NMC certified?
No template can be, and any template claiming to be should be a red flag. This is a clinician-authored document aligned with UK consent standards. You remain professionally responsible for your consent process.

Ready to deploy?

Single ZIP, instant download, single-clinic licence. Open on Mac, PC, or iPad.

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