I hereby permit Doctor Mohamed Salem and his allied clinic providers of the same services to perform the following medical treatment or procedure

I understand that the above procedure might have an alternative method of treatment, risks involved and the possibility of complications. Other risks might occur aside from the expected risks with any surgical and medical procedure.

Enough time was given in discussing my condition and the procedure by my health care providers and all my queries were answered.

I am aware that the outcome of medical and surgical treatment is not always predictable. No guarantee or assurance has been given to me by anyone of the result that might be obtained. I have been informed about the consequences if I refuse this procedure.

I agree that facility and its dermatologist and other allied health care providers shall not be held liable for any consequences of the treatment rendered or any treatment which the client may choose to take in other clinic, during or after Padra Medical Center

I agree to follow all the Pre and Post treatment instructions.

Hyaluronidase Consent

I agree to the hyaluronidase injection to dissolve a previous filler, and I am aware of all the complications and side effects such as Redness, swelling and bruising, and the number of sessions is up to 3 sessions.

اذابة الفيلر

أقر بالموافقة على حقن الهيالورينداز لاذابة فيلر سابق و أنا على علم بجميع المضاعفات و الاثار الجانبية مثل الاحمرار و التورم و الكدمات و أن عدد الجلسات يصل الى 3 جلسات.