Before your consultation
Patient registration and medical history
Contact details, medical history, medications, allergies and previous surgery. Dr. ElKhoury reads it before you meet.
Four forms
Which form, and when
Before your first photographs
Photograph consent you choose each use
What your before and after photographs are used for. Each use is a separate Yes or No, and you can withdraw at any time.
For the clinic
Botulinum toxin units and areas
Dr. ElKhoury's record of each toxin treatment: the product, the areas on a face chart, and the units per area.
At your pre-operative visit
Consent to surgery and anaesthesia
Completed and signed with Dr. ElKhoury at the clinic. Read it at home first, and bring your questions.
How it works
Three steps, about ten minutes
- Fill it in
One section at a time. Answer in English, French or Arabic. Clinic-only boxes are left for the clinic.
- Sign
With your finger on a phone, or a mouse on a computer. Today's date is added for you.
- Send it
The signed PDF is saved to your device. Send it on WhatsApp to +961 1 697 739, or bring it to your appointment.
Questions
Before you start
Is what I type sent to the clinic or stored online?
No. The form runs inside your browser. The signed PDF is made on your device and saved there. The clinic only receives it when you send it.
I would rather write by hand.
Download the PDF, print it, fill it in with a pen and bring it to your appointment. Printed copies are also available at the clinic.
Can I fill in the PDF itself on a computer?
Yes. The downloaded PDFs have typing boxes and tick boxes. Open them in Adobe Acrobat Reader, or in your phone's PDF app, and use Fill & Sign.
I made a mistake after signing.
Fill the form in again and send the new copy. Say in your message that it replaces the first one.
The patient is under 18.
A parent or guardian signs as well. The form asks for this at the signature step.