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Patient Consultation Record

If you have any allergic reactions to any of the ingredients, please avoid the treatment.


If you tend to develop keloids or granulomas, have inflamed or infected skin, cold sores or general infection, you should forego treatment.


Dermal fillers should not be injected over permanent implants.


Please inform your practitioner before treatment if you are taking anticoagulants, so your practitioner can decide whether treatment is suitable for you. This class of medication includes: 

Pregnant women, breastfeeding mothers, and adolescents under 18 years of age should not be treated with dermal fillers.

Please inform your practitioner of any health conditions you have or have had. These include in particular cardiovascular diseases, coagulation or blood disorders, autoimmune diseases, diabetes, skin infections, epilepsy, liver or kidney problems, a tendency to form keloids or scars, or allergies.


If you take any medications or health supplements, have had cosmetic procedures or previous treatment with other implantation materials and had any complications, please inform your practitioner. 

Please remember to use the bathroom prior to attending your appointment and note that children under the age of 18 are not permitted in our clinics, both due to OH&S regulations.

Thank you for your co-operation, and we look forward to seeing your gorgeous face in our clinic soon!


At Luxe Lips, we take the health and well-being of our clients seriously so if you are unwell with a fever, runny nose, cough, and/or any other flu symptoms, we kindly ask that you reschedule. 

We know that rescheduling your appointment can be frustrating, but due to the nature of the current situation, it is simply not worth putting your practitioner and other clients at risk.


Please don't forget to inform us if you have had a dosage of COVID vaccine within 2 weeks of your appointment, as we strongly recommend to reschedule in order to prevent any adverse effects.

Thank you so much for understanding!

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