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Appointment Form

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Full Name:*

Date of Birth:*

Contact Number:*

Email*

Procedure Date*

Consent to Procedure

I, the undersigned, confirm my consent to undergo the non-surgical blepharoplasty procedure.

Procedure Description

Non-surgical blepharoplasty is a cosmetic procedure aimed at improving the condition of the eyelid skin using advanced technology. The procedure involves minimal intervention, does not require surgical incisions, and provides aesthetic enhancement.

Informed Consent

The purpose, process, and expected results of the procedure have been explained to me. - I have been informed about possible sensations during the procedure (warmth, tingling) and potential temporary side effects (redness, slight swelling). - I understand that achieving optimal results may require a course of treatments.

Recommendations and Safety Measures

I agree to follow all pre- and post-procedure recommendations provided by the specialist, including proper skincare and avoiding direct sun exposure. - I acknowledge that failure to follow these recommendations may impact the results of the procedure.

Medical Information

Do you have any chronic conditions?

Yes

Do you have any allergies?

Yes

I have informed the specialist of all my medical conditions, allergies, and medications I am currently taking.

Disclaimer

I understand that the outcome of the procedure may vary depending on my individual characteristics and is not fully guaranteed.

Signatures

I confirm that I have read and understood this document, asked all relevant questions, and received comprehensive answers.

Client Signature:*

Specialist Signature:*

Date

For Specialist Use Only

Procedure Protocol Number:

Special Notes:

This document will be stored in the client’s personal file and remains confidential.

Success Stories

Real Clients, Real Results - Hear What The Clients Have to Say

James D

I hope you are doing well. I just wanted to give you an update that so far my eyes has been healing well and especially i'm so happy with the results. I fell very pretty and confident with the procedure that you've done. I'm absolutely loving it

Sophia W.

It has now been 2.5 weeks and the swelling has gone down by 98% small bruising has almost disappeared and the scar is also healing well ( I am using Kelo-Cote silicon scar gel and it is helping alot !) . I am very happy with results so far and i can't tell you enough how much of a difference it has made for me . I can't wait to see the final healed results. Thank You so much

Emma R.

I found the best aesthetic specialist in London! The treatments were professional, effective, and natural-looking. All thanks to Minura once again.

Michael T.

My jawline and lips look so much better after my treatments. Everything was tailored perfectly to my face!

Chloe B.

If you're considering non-surgical blepharoplasty treatment, this is the place to go. Safe, professional, and amazing results!