What should a botox and filler consent form include?
A botox or filler consent form should check the client is 18 or over, take an emergency contact and their GP, then ask about pregnancy and breastfeeding, allergies to local anaesthetic, lidocaine or hyaluronic acid, bleeding or clotting disorders and autoimmune conditions, blood thinners, an active cold sore or infection, botox or filler in the last two weeks and current medications. It explains the risks, including the rare serious ones, asks for photo consent separately and ends with consent and a signature. In England it is an offence to give botulinum toxin or a cosmetic filler injection to anyone under 18, with a parent’s permission or not. Check the final wording with your insurer.
We make Covered Beauty, which has a ready-made injectables form, so we’ve said where it fits. Nothing here is legal or medical advice. Your insurer’s rules and your professional body’s guidance come first.
What is the age rule?
Under section 1 of the Botulinum Toxin and Cosmetic Fillers (Children) Act 2021, it is an offence to administer botulinum toxin, or a subcutaneous, submucous or intradermal injection of a filler for a cosmetic purpose, to anyone under 18 in England. There are defences for a registered medical practitioner, for a regulated health professional acting on a doctor’s directions, and for someone who took reasonable steps to establish the client’s age and reasonably believed they were 18 or over.
Section 2 goes further: it is also an offence for a person carrying on a business to arrange it. GOV.UK’s guidance for businesses says that includes booking an appointment, that a parent’s consent is not a defence, and that looking over 18 isn’t enough. It suggests checking age with a document, when the client books and again on the day.
The offences are for treatment given in England. We haven’t covered the rules for the rest of the UK, so ask your insurer and your regulator what applies where you work. Our form’s note to the client says the treatment can’t legally be provided to anyone under 18 in England, and it asks for their date of birth and whether they’re under 18. That puts the age in front of you, but checking it is still your job.
What does our injectables form ask?
Every ready-made form in Covered Beauty starts with the client’s full name, date of birth and home address, so the signed form stands on its own as a record. Then the injectables form asks:
- Are you under 18? (yes or no)
- Emergency contact (name and relationship) (written answer)
- GP name (so we can follow up if needed) (written answer)
- Do you smoke? (yes or no)
- Do you regularly drink alcohol? (yes or no)
- Are you pregnant, breastfeeding, or trying to conceive? (yes or no)
- Any known allergy to local anaesthetic, lidocaine, or hyaluronic acid? (yes or no)
- Do you have a bleeding or clotting disorder, or an autoimmune condition? (yes or no)
- Are you taking blood thinners, aspirin, or anti-inflammatory medication regularly? (yes or no)
- Do you have an active cold sore, skin infection, or breakout in the treatment area today? (yes or no)
- Have you had Botox or filler anywhere on your face in the last 2 weeks? (yes or no)
- Please list current medications and any relevant medical history (written answer)
- I’ve had the chance to ask questions and I understand the risks explained above. (a tick to agree)
- I agree to before/after photos being taken for my clinical record (not for marketing unless I separately agree). (a tick to agree)
- I confirm the information above is accurate, understand incomplete answers increase my risk, and consent to this treatment and any emergency care my practitioner judges necessary. (a tick to agree)
Between the questions, its note to the client says bruising, swelling, tenderness and temporary asymmetry are common and usually settle within days, that rare but serious complications, including vascular occlusion, are possible, and to get in touch straight away after treatment with severe pain, unusual blanching of the skin or vision changes.
Because it’s a needle treatment, the form also opens with a stronger note for you: check it against your insurer’s requirements and your professional body’s guidance before you switch it on. Clients never see that note, and it isn’t on the signed form.
What about photos and the treatment record?
- Photos have their own tick, which starts unticked. It says the photos are for the clinical record and not for marketing unless the client agrees separately. Ask for marketing permission on its own.
- Our form is the consent, not your treatment record. It doesn’t record the product, the areas treated or the batch, so keep those in the client’s notes.
How do you keep signed forms safe?
Health answers are special category data under UK GDPR, so they need care. Read consent forms and UK GDPR for salons for explicit consent, how long to keep a form and what to do when a client asks you to delete theirs.
How do you get it signed before they arrive?
A clipboard at the start of an appointment eats into it, and it’s the wrong moment to find an answer that rules a treatment out. Covered Beauty gives you three ways to have the form done first:
- With their booking. Link the form to your treatments and it goes out with the confirmation, with a reminder 48 hours before if it isn’t done.
- A private link. Email it, or copy it into WhatsApp or a text. It works for 14 days and only for that client.
- On your phone or tablet. Set a kiosk PIN, then use Hand to client. It shows only their forms until someone from your team enters the PIN.
The signed form lands on the client’s record, ready to print or download as a PDF, and Covered Beauty keeps it for 7 years from the appointment, or from the day it was signed for a form filled in without a booking, while your account is open. See how online consultation forms work. Try the injectables form free for a week, with no card needed. Forms are on every plan, from £9 a month.
Download the free blank form
It’s an A4 PDF with every question our form asks (listed above), boxes to tick yes or no, a line for your business name, and lines for the client’s signature and yours with the date. The extra questions we suggest aren’t on it, so write in the ones you need. The foot of each page says it’s a free template from Covered Beauty. Print it, keep a few on a clipboard, and check the wording with your insurer first.
Paper still means the client fills it in once they’re in your room. Send this form before they arrive, free for a week, with no card needed.
Questions from aesthetics clinics
Can I treat a 17-year-old if a parent agrees?
Not in England. The Botulinum Toxin and Cosmetic Fillers (Children) Act 2021 makes it an offence to administer botulinum toxin, or a filler injected for a cosmetic purpose, to anyone under 18, and GOV.UK’s guidance for businesses says consent is not a defence. The defences are for registered doctors, regulated health professionals acting on a doctor’s directions, and someone who took reasonable steps to check the age and reasonably believed the client was 18 or over.
Is it an offence to book an appointment for someone under 18?
Yes, in England. Section 2 covers a business making arrangements for it, and GOV.UK’s guidance for businesses says that includes booking an appointment. It suggests checking age with a passport, a photo driving licence or a PASS-marked photo ID, when booking and again on the day.
Does the form need signing every visit?
In Covered Beauty, when the form comes with a booking and the client filled in the same form in the last 6 months, they see their previous answers, confirm nothing has changed and sign again. If anything has changed, they fill in the whole form afresh. Whether your insurer wants a new form each time is theirs to say, so ask them.
Do I need a separate form for lip filler?
Our ready-made form is one form for botox, dermal filler, skin boosters and similar treatments, with one set of health questions and one risk note. Your insurer may want more for some treatments, so check before you use it.
How long should I keep botox and filler consent forms?
Ask your insurer, because they may want them kept longer than you’d think. Covered Beauty keeps signed forms for 7 years from the appointment, or from the day it was signed for a form filled in without a booking, while your account is open. If you ever leave, export them within 30 days of your account ending, as our terms say, so you still have them.
Is there a free botox consent form template with no sign-up?
Yes. The blank form on this page is free to download and print, with no sign-up. You can also try the same form in Covered Beauty free for a week, edit every word and send it before the appointment.
Sources
Each page was read on 12 November 2026. Our own form questions are printed as Covered Beauty’s ready-made form asks them today.
Other consultation form guides
Every free blank form, sorted by treatment, is on free salon consultation form templates. Or read what to put in a consultation form for:
What else should you read?
Booking app for aesthetics clinics in the UK
Medical history and consent signed before the appointment, kept with the record, and deposits on longer treatments.
Read the guideWhat to put in a client medical history form
The one-off health questions for a new client, how often to review them, and how they sit with each treatment's own form.
Read the guideConsent forms and GDPR: a guide for UK beauty salons
What counts as health data, the consent you need, how long to keep forms and what to do when a client asks you to delete them.
Read the guideOnline consultation forms
Send a private link or hand over your tablet, with or without a booking. Signed forms land on the client’s record.
See how it works
