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$127.00
A complete, editable informed consent form for botulinum toxin treatments — Botox, Dysport, Jeuveau, and Xeomin. Covers risks, alternatives, off-label disclosure, and patient acknowledgment. Built to the elements of informed consent that the free lead-magnet forms leave out.
Any clinic or licensed provider administering neurotoxin — med spas, aesthetic practices, mobile injectors, and dermatology or plastic surgery offices adding injectables. If you’re a registered nurse, nurse practitioner, PA, or physician injecting Botox, Dysport, Jeuveau, or Xeomin, you need documented informed consent on file before every treatment. This template gives you a defensible, attorney-reviewed version rather than a free form-builder PDF that wasn’t written for medical-legal use.
Most consent forms ranking online are lead magnets from software companies or generic template aggregators. They’re designed to capture your email, not to hold up to a board inquiry. They routinely omit off-label disclosure (every cosmetic neurotoxin use is technically off-label), skip the no-guarantee-of-results language that prevents refund disputes, and carry no attorney review. This document was drafted and reviewed by licensed healthcare attorneys who work with cash-pay clinics every day.
Download the editable Word file, add your clinic name, logo, and medical director, and have your medical director review it once for your practice. From there it’s ready for every patient. You also get a clean PDF for clinics that prefer paper intake. When neurotoxin labeling or your state’s rules change, we update the template and you get the new version free for 12 months.
The template is drafted and reviewed by licensed healthcare attorneys and includes the recognized elements of informed consent. It’s a professional starting point — you customize it with your clinic details and have your medical director confirm it fits your practice and state. It is not a substitute for advice on your specific situation.
An editable Microsoft Word (.docx) file plus a ready-to-print PDF, delivered instantly after checkout. Edit it on any device.
The base template applies nationally with state notes built in. Dedicated California, Texas, and Florida editions are available, and more states are added regularly. All-Access members get every state edition.
Yes. The form covers botulinum toxin treatments generally and names the common brands, so it works across your neurotoxin menu.
If we revise the template because regulations or product labeling change within 12 months of your purchase, you get the updated version at no extra cost. All-Access members get updates for as long as they subscribe.
★★★★★ 4.9 · 312 reviews
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“Exactly what our med spa needed. Our attorney reviewed it and made only two small tweaks. Saved us a $1,500 drafting fee.”
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“Bought the free versions before — this is on another level. The off-label section alone is worth it. Downloaded in seconds.”
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“Got the Texas edition. The delegation language was the part I kept getting wrong on my own. Now it’s handled.”
