Withdrawal of Consent Form

1. Purpose of this form

This form allows you to withdraw your consent for certain processing activities carried out by SKS Innovation SA, Chemin du Laviau 6, 1805 Jongny ("Metaesthetics", "we", "us") where we rely on your consent as the legal basis for processing (including explicit consent where required for special categories of personal data).

Withdrawal of consent does not affect the lawfulness of processing based on your consent before its withdrawal.

Please note that if you withdraw consent for certain features, some parts of the Services may no longer be available (for example, features involving processing of photographs/images or health-related information).

2. Your details

• Full name: _______________
• Email address linked to your account: _______________
• Phone number (optional): _______________
• Username / Account ID (optional): _______________
• Date: ____ / ____ / ______

3. Consent(s) you wish to withdraw

Please tick the consent(s) you wish to withdraw (you may select more than one):

Special categories of personal data

I withdraw my consent for Metaesthetics to process health-related information that I provide through the Services (e.g., contraindications, recovery progress, side effects), where Metaesthetics relies on consent as the legal basis.

Photographs / images

I withdraw my consent for Metaesthetics to process photographs/images that I upload through the Services (e.g., facial images, body images, before/after images, recovery photos), where Metaesthetics relies on consent as the legal basis.

Facial/body scan measurements & visualisations

I withdraw my consent for Metaesthetics to generate and process scan-derived measurements, mappings, visualisations and related personalised outputs based on images I provide, where Metaesthetics relies on consent as the legal basis.

Personalisation, AI-based recommendations and profiling (where based on consent)

I withdraw my consent for personalised recommendations and profiling to the extent such processing is based on consent.

Non-essential cookies / similar technologies

I withdraw my consent for non-essential cookies and similar tools (where applicable).

Marketing communications

I withdraw my consent to receive newsletters, special offers and marketing communications.

4. Scope of withdrawal

• I want my withdrawal to apply only going forward (no further processing for the selected purposes).
• I also request the deletion of data previously processed based on my consent to the extent legally possible.

5. Acknowledgement of limitations

Please note that:

• Metaesthetics may retain certain personal data where necessary for compliance with legal obligations, security, or the establishment, exercise or defence of legal claims.
• Partner clinics/providers may process your personal data under their own responsibility (as independent controllers) for the provision of medical services, including clinical documentation and medical record retention obligations. Withdrawing consent from Metaesthetics does not automatically remove your data from a clinic's systems.

6. Signature

Signature (or typed name if submitted electronically): _______________