I consent to Dr Bela to conduct an online aesthetic consultation upon my request in order to gain information on possible future aesthetic treatments, its benefits, potential risks and contraindications. I understand that the aim of the consultation is giving me comprehensive information on possible treatment options which allows me to make an informed decision whether to proceed with treatments in the future or not.
I confirm that I will answer all questions regarding my medical history (medical conditions, allergies, previous procedures) truthfully. I understand the consultation is confidential and it will not be recorded unless I request it otherwise in writing. I agree to have my personal data - name, date of birth, mobile number and email address - as well as medical records, photographs and consultation notes - entered and managed in the clinic database, in compliance with the appropriate data protection laws and regulations.
Your name (electronic signature)
Dr Bela will confirm the receipt of your emails, suggest some possible dates and times and then you can go to STEP 4.
I consent to Dr Bela to conduct an online aesthetic consultation upon my request in order to gain information on possible future aesthetic treatments, its benefits, potential risks and contraindications. I understand that the aim of the consultation is giving me comprehensive information on possible treatment options which allows me to make an informed decision whether to proceed with treatments in the future or not.
I confirm that I will answer all questions regarding my medical history (medical conditions, allergies, previous procedures) truthfully. I understand the consultation is confidential and it will not be recorded unless I request it otherwise in writing. I agree to have my personal data - name, date of birth, mobile number and email address - as well as medical records, photographs and consultation notes - entered and managed in the clinic database, in compliance with the appropriate data protection laws and regulations.
Your name (electronic signature)
Dr Bela will confirm the receipt of your emails, suggest some possible dates and times and then you can go to STEP 4.