Thisisveryimportant informationregarding theAmericanAcademyofFacial

EstheticsLevelIIAdvancedBotulinumToxinCourse.

Pleaseread all informationcarefully.

Pleasesubmit theReservationForm alongwithacopyofyour currentstate practicinglicenseandthedeclarations/coverpageofyour malpracticeinsurance.

Pleasefax oremailtheseitemsto Tiffiniat:

Fax:216-395-0110or216-672-5230Email:

***If you haveanyquestionsabout thecourse,pleasecontactTiffiniby calling

800-952-0521Ext.703 orvia email.

Hereistheagendafor theAdvancedBotulinumToxinLevelIICourse:

*Note: You must haveyour BotulinumToxinLevelIIonlinetrainingcompleted with a passing gradeto attend theonsitecourse

Registration / 7:30 AM / Pleasebe prompt
BotulinumToxinIntro / 8:00 AM

LivePatient Botulinum 8:30 AM to 12:00 PM

Toxin

*Patientswillnot be allowedto enterthecourseuntil9AM. Team Members

We still haveavailabilityforyouto bring additionalstaffmemberswith youto thecourse. Inorder to attendasa teammember, yourguestsmustnot be a nurse,a doctorofany profession,or a possible injector.All nameswill be verifiedthroughthestateboardsandfulltuitionwill be chargedif this policyis not carriedout.

AAFEMembers- your first teammember isFREE.All otherteam membersadmission

costis$395perperson.Payment isrequiredeveniftheteam membersittinginonthe courseisyourmodelpatient.Pleaseletus knowassoonaspossibleifyouplan to bringany additionalteam members.

ModelPatients

For thebestlearningexperience,pleasebringyour own model patients.Ifneedbe,it is likelythatyouwillfinda modelpatientatthecourse.Youcan bringup to2patientsper day.Pleaseletyourmodelpatientsknowthattheymust beavailableforapproximately3-4 hours,asthisisateachingcourse.

Attendeesaresolely responsiblefortreatmentoftheirpatientsatthiscourse.You will treatyourpatientsasyou wouldin youroffice.

Thehands-onportionofthecoursewill be arrangedinGroupsA, B andCandisdependent onmeetingsize.Groupswill bedeterminedthemorningofthemeeting.Patients should arrivewhenthehands-onportionofthecoursebeginsorwhenyouhavea better understandingofwhat groupyouarein. Ifyou choosenot tobring a modelpatient, you mayobservethehands-onportionofthecourse.Youmayalso finda patientatthecourse.

Checklistfor LevelIITraining

Pleasebringthefollowing:

• Digital camera to document patient priorto injections.(Cameraphonesworkalso)

• Loupes/headlights if you use them in yourpractice

• Two sterilized dentalanesthetic syringes.(Needles will be provided)

• Yourpreferredlocal anesthetic.

*YOU MAYBRINGYOUROWN FDAAPPROVEDFACIALINJECTABLESTOTHECOURSE* Hereare some tips for choosingamodelpatientfor theLevelIICourse:

In thisupcoming LevelIIcourse,thefacial lines,wrinklesandfoldsthatareidealto treat withBotulinumToxinandDermalFillersareall theareasthatwerecoveredintheAAFE LevelIcourseandthosepatientsrequestingtreatmentforgummysmile, esthetic eyebrows,anatomical lipsculpting, cheekenhancements,“bunny lines”,and down turned cornerofthelips.

Attendeesshould haveexperienceandhavetreatedwithBotulinumToxin

approximately10patientsbefore attendingthis course.

Themodelpatientshouldhavemild,moderateto deepfoldsandlines- thesearethe bestpatientsto train on.

Themodelpatientshouldnot beneedlephobic.

Themodelpatientshouldbeeasytoanesthetizeandbeable totoleratelocal dental anesthesia.

IfyourpatienthasTMJ/myofascialpain andbruxism,theseareaswill be addressed aswell.

Thepatientshouldbehealthy,withnoactiveskin infections,andhaveaclean

medicalhistory.

Patients with neurological,autoimmune andimmunological diseasesarenot the bestcandidates,aswellaspeoplewithlong termsystematicdiseases.

Patients,whobruiseeasily, becauseofmedicationsorotherdiseaseprocesses,may

not begoodcandidates.Themodelpatientmayhavesomeswellingand/orbruising aftertreatment.

Ifyouareunsureaboutwhethera patient'smedicalconditionisa contraindication to Botoxand/ordermalfillertherapy,pleasecheckwiththeirphysicianpriorto

treatingthematthiscourse.

BotulinumToxin Pre-TreatmentInstructions

In an idealsituation,itisprudentto followsomesimpleguidelinesbeforetreatmentthat can makeall thedifferencebetweenafairresultand/orgreatresult,by reducingsome possiblesideeffectsassociatedwiththeinjections.We realizethisis not alwayspossible; however,minimizingtheserisksisalways desirable.

Avoidalcoholicbeveragesat least 24hourspriorto treatment. Alcoholmaythinthe bloodwhichwill increasetheriskofbruising.

Avoidanti-inflammatoryorbloodthinningmedicationsideally,fora periodoftwo weeksbeforetreatment. MedicationsandsupplementssuchasAspirin,Vitamin E, Gingko Biloba, St.John’sWart,Ibuprofen, Motrin,Advil,Aleve,andotherNSAIDSare all bloodthinningandcan increasetheriskofbruising/swellingafterinjections.

Scheduleappointmentatleast 2weekspriorto a specialevent whichmaybe occurring,i.e.,wedding,vacation,etc. It isnot desirabletohaveaveryspecialevent occurringandbebruisedfromaninjectionwhichcouldhavebeenavoided.

Everymodel patientmustsignaninformedconsentprior to treatment.Consents will be provided ateachcourse andtherewillbe noexceptions.

We havetherightto refusetreatmenttoanypatient.

Ifyou haveany questionsabout yourpatient,pleaseemailDr.Malcmacherat

.

All coursecompletioncertificatesandcontinuingeducationcreditswill beawardedto attendeeswhenall coursetuition, team memberverification,andcourse/productfeeshave beenreconciled.

IMPORTANT: CancelationPolicy

Registration is fullyrefundable onlyifcourseiscanceled byTheAmerican AcademyofFacial Esthetics. We reservetheright to cancel acourse for anyreason andcannotbe responsible for hotel deposits or non-refundable airline tickets orother associatedfees. Hotel locations may changedependingon circumstances beyond our control. No refunds for online courses. Wetake no responsibilityregardingstatemedical or dental board requirements. Participants are responsible fordeterminingwhethertheyareableto perform theseprocedures at our courses and in their own practices. We arenotresponsible fordecisions or changes madebystate medical/dental boardabout their statepracticeacts prior to our courses. Registration is also fully refundableno laterthan5 PM samedate onemonth beforecourseminus $775 handlingfee. No refunds after samedate onemonth beforethe firstcoursethatyou registered for. At our discretion,you maybeable to changeto anotherdate and location but therewillbeno refund available shouldyou cancel outof that courseor failto show up.

ReservationFormforFacialEstheticsAdvancedLevelII Pleasebesuretoreadallpre-courseinformationpriortocompletingthisform.

Nameasyou wouldlikeittoappearonyourcertificate:

CourseDatesandCityLocation______

AttendingTeamMembers

Inordertoattendasateammember,yourguestsmustnotbeanurse,adoctorofanyprofession,ora possibleinjector.Allnameswillbeverifiedthroughthestateboardsandfulltuitionwillbechargedifthis

policyisnotcarriedout.

PleasenoteTeamMemberinfoonly-Patientsdonotneedtobereported.

1. Botulinum Toxin/Dermal Fillers

2.Botulinum Toxin/DermalFillers

BotoxandDermalFillerswillbeavailableforpurchaseatthecourse.

**Weacceptcreditcardsonly**

Pleasefaxoremailthisformalongwithlicenseand malpracticeinsurance.

FAX#216-395-0110or216-672-5230

Email: