PERSONAL DETAILS

SCREENING QUESTIONNAIRE

 

ACCEPTANCE & ACKNOWLEDGEMENT

Are you prepared to help your health in recovery so that risks are lower and results are better eg. give up smoking 4 weeks before and 4 weeks after surgery, stay out of sun, purchase cremes to help in scar reduction, eat well and exercise?     

I have read, understand and       to ABA Terms & Conditions.

**electronic signature or text insertion of name is deemed as signing