Please fill out the following Statement of Responsibility form if you have an appointment scheduled at THE BOX by Carolina Mazzoni.

NOTE: This form is valid for one year. If you have recently undergone cosmetic, dermatological or dental treatments, consult your doctor and fill out the form again. Examples of treatments: insertion of Hyaluronic Acid, Botox, Vitamins, Tensor Threads, skin treatments, acne, tooth extraction, etc.

Thank you so much!