1. Products for Injection
   • Participants will need to bring 1 vial of neurotoxins and 1-2 syringes of dermal fillers to inject during the hands-on portion.
     
2. ONE Practice Patient/Model
   • You will inject this ONE model with BOTH neurotoxins and dermal fillers
   • Model selection instructions and model arrival time will be assigned in confirmation of registration
3. Patient Charts for Your Model
   • Please click here to download sample patient chart templates
4. Anesthetic Medication
   • Participants must bring a topical BLT anesthetic cream (Benzocaine 20%, Lidocaine 6%, Tetracaine 4%) which can be ordered from a compounding pharmacy
5. Camera/Smart Phone for Pre-Injection Photos
6. Face Mask
   • Each participant and model is required to bring and wear a face mask during the training.

AAI will provide saline for neurotoxin reconstitution and all medical supplies (i.e. gloves, needles, etc.)

1. EXPERIENCE
   • No prior experience with neurotoxins or dermal fillers is required
2. PHYSICIAN AUTHORIZATION
   • Each NP, PA, RN, etc. must submit an authorization form, signed by his/her supervising physician in order toparticipate in the hands-on portion of this course. See below under "Requirements for PA, NP, RN, etc." for more information and click here to download the authorization form.
3. NO AUDITORS PERMITTED
   • We DO NOT allow observers/auditors to attend the course with you (including office staff, assistants, etc.). Additionally, models may NOT sit through the lecture.
4. CANCELLATIONS
   • Any cancellations must be received at least 14 days prior to the course date to be eligible for a refund. Click here to view our Cancellation Policy.

For each NP, PA, RN, etc, attending our course, who is not legally permitted to practice autonomously, we do require your supervising physician to sign an authorization form for you to be able to participate in the hands-on portion of the course. This form will need to be printed out and signed by your supervising physician, and then uploaded with your registration (which can be done later on in this registration process) or you must fax a copy to us after you submit your online forms.  Click here to view the required Physician Authorization Form.

In states where scope of practice allows for administration of injectables by allied health professionals with less than an RN degree, AAI will allow this medical professional to take part in the course only if they are accompanied by their Medical Director (i.e. MD, DO, PA, and in some states NP) who will pay the standard AAI program auditing fee for the course. We do not allow "observers" to attend.

Aesthetic Advancements Institute, hereinafter referred to as AAI, welcomes the attendance of all licensed Clinicians at their instructional programs. AAI acknowledges that some Clinicians may choose to attend a program located outside their licensing state. In some cases, you may be required to provide hosting state medical board approval for out of state licensee participation. Failure of a Clinician to obtain the necessary approval and proof from the medial board of the hosting state will result in the immediate withdrawal by AAI of the Clinician’s application. A full refund for any deposits received will be issued or applied to a future program being held in the Clinician's state of licensure.

For all NON-independent practitioners (NP, PA, RN, etc.), we require you to have an authorization form signed by your supervising physician.  This form can be completed electronically or you can print a hard copy and upload the completed version below.  (We accept most formats - you can scan and save the form, or even take a photo of the form, and then attach below).  If you are unable to complete the electronic version or attach the form below, you can also email a copy to acamp@aestheticadvancements.com.  Your registration will not be complete until we receive this form.

If you are an NP or PA working as a completely independent practitioner in your state of practice (and are not legally required to have a supervising physician), please complete this form and sign it yourself.

To complete the electronic version, please visit:
https://form.jotform.com/aestheticadvancements/phyauth

To download and print a hard copy for submission, please visit:
https://aestheticadvancements.com/wp-content/uploads/2020/08/Physician-Authorization-Form-8119.pdf 

I have agreed to participate in this interactive hands-on workshop session (the "Workshop") during the Combined Use of Neurotoxins (BoNTA) and Dermal Fillers for Facial Enhancement: Fundamental Techniques educational (CME/CE) program sponsored by Aesthetic Advancements Institute and supported by an independent educational grant from Allergan, Inc. as part of my participation in the educational program.  I will practice facial injection techniques on a volunteer patient of subject (the "Volunteer") prescreened and selected by me, provided by me to be an appropriate candidate for treatment, using my own supplied US FDA approved injectable agents.

I have knowledge of the risks inherent in the subject facial injections and I hereby assume all responsibility of any kind which may arise in connection with my performance of facial injections, including any or all of my acts and omissions in connection therewith.  I hereby agree to indemnify, defend, and hold harmless the program sponsor, Aesthetic Advancements Institute, program supporters, Allergan Inc., and each of their respective affiliates, licensees, assignees and parent, subsidiary and affiliated companies, and the officers, directors, shareholders, employees and agents of all such entities (all of the foregoing, collectively, the "Indemnities"), from and against any and all costs, losses, liabilities, damages and expenses, including reasonable attorneys’ fees and costs, arising out of any claim, complaint, challenge, proceeding or other action, whether by the Volunteer or otherwise, resulting from or arising out of my participation in the workshop and specifically those medical procedures identified below.  I further agree to waive any and all claims of any kind that may arise with respect to Aesthetic Advancements Institute in connection with my participation in the Workshop.

I hold a current license in the state listed below, and with this license I am legally able and plan to perform the following facial aesthetic injection procedures, and have provided evidence of such qualifications. If training outside my state of licensure, I certify that I fall within the scope of practice for my credentials in the state in which this program is being held for training purposes only and have provided such evidence.  Medical procedures to be performed:

Neurotoxins (BoNTA) Injections
Dermal Filler Injections

Waiver of Liability and Assumption of Risk Agreement
COVID-19 Release Agreement

Waiver:

In consideration of Aesthetic Advancements Institute ("AAI") allowing the undersigned to participate in an AAI live hands-on training course ("live training"), I for myself, my heirs, personal representative or assigns, do hereby release, waive, discharge, and covenant not to sue AAI, it’s owner, adminstrators, employees, agents and independent contracts from liability from any and all potential claims related to or resulting in personal injury or illnesses (including death) and property loss arising from any COVID-19 transmission that results from the undersigned being present at the facility and participating in training.

Assumption of Risk:

I understand that AAI has put into place reasonable preventative measures aimed at reducing the risk of exposure to COVID-19 at the live training.  I also understand that due to the nature of this virus, there are certain inherent risks that cannot be eliminated regardless of the care taken to avoid COVID-19 transmission at the live training.  I understand that possible exposure to the COVID-19 virus may result in the following: a positive COVID-19 diagnosis, quarantine or self-isolation, hospitalization, ICU treatment, possible need for intubation, other potential complications, the risk of death, and other risks that may not be known at this time.

I assume all of these risks and hereby assert that my participation is voluntary and that I knowingly assume all such risks, and while aware of these risks, I have elected to be present at the facility and participate in the live training. 

Indemnification and Hold Harmless:

I also agree to indemnify and hold harmless AAI, its owner, administrators, employees, agents and independent contractors from any and all claims, actions, suits, costs, expenses, damages and liabilities including attorney fees resulting from any COVID-19 transmission that occurs from to being present at the facility and participating in the live training.

Acknowledgement of Understanding:

I have read this waiver of liability, assumption of risk, and indemnity agreement, and fully understand its terms. I acknowledge that I am signing the agreement freely and voluntarily and intend by my signature to be a complete and unconditional release of all liability to the greatest extent allowed by law.