medical history

social media posting permission

This signature is to acknowledge that you are aware that your photos and/or videos may be used by Filler-Up NJ for social media promotional purposes; your identity will be obscured. Also feel free to share your results and tag us!

COVID CONSENT:

Filler-Up is following all CDC regulations to prevent the exposure or spread of the COVID-19 Virus. The entire Vehicle is properly sanitzed and cleaned throughly before and after each patient. Although we are sanitizing and following protocol with all of our staff we are able to guarantee your safety from COVID and other airborne illness. By signing below you have consented to treatment in the Filler-Up Vehicle.