MATA Models Application Form

Please fill out the form below to apply for our MATA Volunteer Patients Programme.  Stand out from other volunteer patients by submitting as much information as you can.  Please refer to our terms and conditions before making you application.

  • If you are suitable for treatment, please tell us the area you would like to have treated. You can select more than one area. If you choose 'other' please give details in the 'message us' box.
  • Please tell us which treatment you would like to have. You can select more than one option. Suitability for treatment is determined by a full health & lifestyle assessment and not all treatments may be available or appropriate for you. If you choose 'other' please give details in the 'message us' box.
  • Date Format: DD slash MM slash YYYY
    We need to know this as not all treatments are suitable for all ages. Please enter as dd/mm/yyyy.
  • Please tell us of any previous cosmetic/aesthetics you have had with as much detail as possible, e.g. "BOTOX to Crow's feet". If you have not any previous treatments, please enter 'NONE'.
  • We need to know this as some treatments can only be repeated after a suitable delay. If you have not had any previous treatment, please enter 'NONE'.
  • Please tell us of any allergies you might have. We will take a full medical history and consent before treatment if you are selected to be a volunteer patient.
  • This is only a guide but will help our clinicians plan your
  • We need to know this to help us plan treatment times with our tutors and practitioners.
  • Please give us the best telephone number to contact you regarding appointments etc.
  • For volunteer patients who would like injectable treatments, we require a photo taken in natural light without make-up.
    Accepted file types: jpg, gif, png.
  • This field is for validation purposes and should be left unchanged.