By booking your appointment, it is considered that you have read, understood and accepted all of the T&Cs. If you have any questions or concerns please contact us: email@example.com
Where we collect information about your health or medical circumstances, we have a legal obligation to collect this information for health & safety and insurance purposes and only do so with your explicit consent. The privacy and security of your data is very important to us and we will only use health related information for the purposes described on this form and in our Privacy Notice.
We understand that life happens and that you may need to cancel your appointment. We do however require a minimum of 72 hours notice of cancellation of all appointments. Cancellation/amendments of appointments can be made by email: firstname.lastname@example.org or whatsapp: 0852364962
Patients that fail to provide 72 hour notice of cancellation/amendment will be charged the consultation fee for all missed consultations and 50% of the cost associated with a missed treatment appointment.
Please arrive on time for your appointment. Patients arriving more than 10 minutes late may be asked to reschedule their appointment and will be charged in accordance with the cancellation policy.
Patients unsuitable for treatment on the day:
Patients deemed unsuitable for treatment will be charged the consultation fee. Please carefully read the appropriate FAQ on our website prior to attending. There is no obligation for treatment to be performed if it is deemed inappropriate for you.
Consultation and Treatment Plan:
The treatment plan must be commenced within 3 months of the consultation otherwise a new consultation will be required.
Please be aware that the outcome of the consultation may be information and advice that you are unsuitable for treatment and you will not be entitled to a refund of your consultation fee.
All patients are scheduled for a review appointment free of charge. Review appointments are scheduled between 2-3 weeks post treatment as this is the ideal time to assess your results. If you do not attend your review appointment or do not cancel with sufficient notice you will be charged for any rescheduled reviews.
It is important that you provide all medical history asked of you. The Glow Clinic and staff will not be held liable for any damage caused because of withheld information or failure to follow instructions.
Dental Council Code of Practice:
The Use of Botulinum Toxin and Dermal Fillers: It is the view of the dental council that the use of botulinum toxin and dermal fillers for cosmetic treatments is not the practice of dentistry. The dental council acknowledges that the use of botulinum toxins or dermal fillers may be justified in exceptional circumstances, for example, in the treatment of temporomandibular joint disorder/dysfunction of the management of chronic pain. It is expected that in this context the treatment will be undertaken by dentists with the appropriate education, training and competence; and the treatment must be for an anticipated health gain. Only products authorised by the Irish Medicines Board can be used, even if the indication for which they are to be used is not authorised. The general conditions of use set out in the Summary of Product Characteristics including contraindications, warnings, precautions and monitoring requirements should be complied with so far as they are relevant to the proposed use.
Obligations on Registered Dentists: As a registered dentist you have the following obligations
if you use botulinum toxin and dermal fillers for cosmetic treatments. You must only provide these treatments if you have undertaken additional education and training, and attained the necessary competence. You must ensure that you are competent to reliably obtain written, valid and informed consent for cosmetic procedures. The patient must sign and be provided with a copy of this Code of Practice as part of the consent process. You must be aware of the conditions for the authorisation of products you use and the advice that different preparations of botulinum toxin are not interchangeable. You must have appropriate indemnity insurance cover. You must not in any way promote, market or associate these procedures with the promotion or marketing of your dental practice as a dentist. You must display a code of practice prominently in your practice and it must be situated in a place where a patient could reasonably be expected to see it before treatment.