Have I covered everything on my consultation form?

[jcs]

I have been working on this for days! I keep looking at other info on here and keep changing it lol. Have i missed anything or would you delete or add something else? I will have a separate profile/treatments. I just want this signed and and stored! I really value your opinions. Many thanks to you all xx

Client Consultation Form
Name:____________________________________________ Date of birth: __________________
Email: __________________________________Tel/Mob: _________________________________
Doctors signature required if you suffer with any of the following contra- indications ? Haemophilia, Diabetes, Medical Oedema, Arthritis, Nervous or Psychotic conditions, Recent Operations on Hands/Feet, Inflamed Nerve, Acute rheumatism . I suffer with_________________ I do not suffer from any of the above conditions (initial) _____ Are you are being treated for anything by a GP Dermatologist or any other practitioner? Yes/No Please provide details ___________________________________________________________
Doctors Signature I do not have any objection to my patient _________________________________ (name of Patient) receiving Nail and Beauty treatment/s
Doctors Signature/Stamp __________________________________ Date _____________
Restricted Contra-indications Are you currently suffering from any of the following? Fever, Infectious or contagious diseases, Under the influence of recreational drugs or alcohol, Diarrhoea and Vomiting ,Undiagnosed lumps or bumps, Inflammation, cuts, bruises, abrasions, Broken bones, scar tissue (2 years for major operations and 6 months for small scars), Recent fractures (minimum 2 months) , Repetitive strain injury, carpal tunnel syndrome, Nail separation, Eczema, Psoriasis, Dermatitis, Warts. I suffer with _____________________________________ I am currently not suffering from any of the listed (initial) ________
Are you sensitive to any cosmetic ingredients or do you suffer from a nut allergy or any other allergy? No/Yes, I am sensitive to ____________________________________________________
Do you have any condition that could affect service options such as, heart or circulatory conditions, cancer, slow healing, Epilepsy any skin/nail conditions or any other health problems not covered above? No/Yes If yes please ___________________________________________
I understand that I am responsible for notifying the nail technician of any changes in the future prior to any treatment. I understand that I CANNOT hold the nail technician responsible if I have knowingly been untruthful.
Client signature _______________________________________ Date _____________________

Under 16 years I have read the above and sign this consultation form on behalf of my daughter (Name) __________________________________ (who is not under 14 but under 16). I also give my consent for her to have the following (Nail/Beauty) treatment/s _____________________________
Parent/guardian signature _____________________________________ Date _________________

 

[geeg]

I think it looks frightfully scary and off putting. You may not have forgotten anything but neither are you performing major surgery.

I think the whole form could be done in a much less intimidating way and give you much more pertinent feed back about the things YOU need to know to help you provide the right service ( which is why we consult with the client in the first place)!

You should be able to see most contra-indications that are pertinent to a nail service yourself and as for the list of medical conditions ... These can be covered less specifically and more broadly in a Few simple sentences without being quite so literal. I think the whole thing is way over the top way too intrusive and way to personal. If I were asked to fill in this form before a service I would refuse ... Id rather walk out the door! No way would I give that sort of information about myself to a nail technician.

You can purchase consultation forms that are all done for you with all the information you need to know.

 

[jcs]

I will bin this! You did make me laugh with the surgery comment. I get your drift loud and clear and thank you for pointing me in the right direction xx

 

[geeg]

I will bin this! You did make me laugh with the surgery comment. I get your drift loud and clear and thank you for pointing me in the right direction xx

If you email me, I will be very glad to send you my consultation (which half the world uses now lol)! Or pm me for it but remember to include your email address.

Sorry you have binned all your work. Some of it was relevant such as the space for parental signature for youths which I would add to mine now rather than creating a separate form. Thanks for taking it so well :hug: you know me ... I have to say it even if some don't want to hear it.

A consultation form should be designed to help you to understand what a client does with her HANDS. High activity, low activity, hobbies, life style, her preference for nail style and length etc so that you can design a service you both agree on.

A good nail technician is prescriptive. We shouldn't be making 'cookie cutter' nails that are the same for every client. Both you and the client should agree on the appropriate length, shape and service and the form you designed didn't tell you any of that.

 

[jcs]

I was planning on a separate form for all the above details you mentioned.
I have pm you with my email address. Would so appreciate yours! Thank you again for your help and cant wait to see yours :hug:

 

[geeg]

I was planning on a separate form for all the above details you mentioned.
I have pm you with my email address. Would so appreciate yours! Thank you again for your help and cant wait to see yours :hug:

Well it's like me :hug: Simple, to the point, and tells me what I as a nail therapist need to know about my clients. You can change it, rearrange it, or use as is.

 

[Conny]

I like your style
Straightforward, meaning no harm, sometimes so honest, it hurts some, but always loving and well-intentioned.

 

[jcs]

Hi all
Could this be the one? Or do i give up and buy them?
Mind in a whirl, surrounded by rubish papers (keep printing/adding/deleting lol)
Geeg have not received any email yet so could not resist having another go haha. Please bare in mind that this is one side of A4. I plan to have analysis and treatment record on the back. I really value all opinions good or bad. Thanks in advance to you all xx


NAILS BY JACKIE ( Mobile _______________________ )
Client Consultation Form
Name: ____________________________________________________________ Date of Birth: ___________________
Address: ___________________________________________________________ Tel (home) : ____________________
Email: _____________________________________________________________ Mobile: ________________________
• Are you sensitive to any cosmetic ingredients or do you suffer from any allergies?
Yes ___ No ____ Details: ____________________________________________________________________
• Are you under medical supervision or taking medication for any condition?
Yes ___ No ____ Details ____________________________________________________________________
• Have you ever had an allergic reaction to any previous beauty treatments?
Yes ___ No ____ Details ____________________________________________________________________
• Do you have any conditions/ ailments (bodily disorders- diseases) that could affect service options such as diabetes, heart or circulatory conditions, cancer, haemophilia, respiratory, slow healing, any skin conditions or any other condition you feel you cannot express on this form?
Yes ___ No ____ Details _____________________________________________________________________
• Are you wearing contact lenses? Yes __ No ___ Are you pregnant or breast feeding? Yes ____ No ___
Declaration
I understand that I am responsible for notifying Nails by Jackie if the above information changes. I am not knowingly suffering from any transferable disease or infection. I understand that I CANNOT hold Nails by Jackie responsible if I have knowingly been untruthful. I agree that if I am unhappy with any service provided by Nails by Jackie I will inform her immediately so this can be rectified (otherwise Nails by Jackie will assume you are happy with the service provided). (Client: I am 16 years or over) Signature: _________________________________ Date: _____________
To be signed only if/ you are under 16 years/Disclaimer required/ Doctors signature required
Under 16 years I have read and answered the consultation questions above on behalf of (Name) _________________ (who is not under 14). I also give my consent for her/him to have the following Nail/Beauty Treatment/s ______________ _________________ ,and for her/him to continue thereafter with follow up appointments if requested. I will contact Nails by Jackie if I wish for my daughter/son to discontinue treatments with Nails by Jackie (please make a note of my mobile number written above).
Parent/guardian signature _________________________________ Date: ________________
DISCLAIMER I have been asked for my Doctors confirmation that there is no objection to me going ahead with ____________________________________treatment/s. I do not wish to do this and wish to go ahead with the treatment/s I have asked for. I take full responsibility for my decision and will not hold Nails by Jackie responsible should I suffer any consequences as a result. Client Signature ________________________________________ Date:_________________
DOCTORS SIGNATURE: I do not have any objection to my patient (name)_____________________________ receiving the following Nail and Beauty treatment/s _________________________________________________________________
Doctors Signature/Stamp ______________________________________ Date __________________

 

[geeg]

I sent it to you this morning. Have you checked your junk mail?

 

[x3stephanie]

I sent it to you this morning. Have you checked your junk mail?

Geeg, could I bother you for a Nail consultation form please?

 

[geeg]

Geeg, could I bother you for a Nail consultation form please?

You need to pm me with the request and your email address, and I would be happy to.

 

[x3stephanie]

You need to pm me with the request and your email address, and I would be happy to.

Thank you very much. I will do it now.

 

[Conny]

Very nice work, but isn't hat way to clinical and serious?
Honestly, i would NEVER sign this before my nails are done. Would you?

What is the point in asking your client-to-be if she/he has a transferable disease? Would they say it to you ( a stranger) if they do?
I always use my nitril gloves (exception to put on the forms... still struggeling with that...).
I made mine based on the one Geeg maild me, ofcourse it's in Dutch, so pretty useless to post is here. Some changes i made:i have columns for:
L&P, Brisa LSG (the smooting gel), Shellac,Brisa Lite (for sculpting), Tips.
So if a customer had an appointment for L&P + Shellac + tips.
I note the date & time, in the column of L&P i note the color acrylic i used, In the column Shellac i note the color Shellac i used (+layering, additives, foils, glitters) and in the column of tips, i note the type of tips and size i used.
That is saving me time ;-)

 

[jcs]

Hi Geeg
Just checked junk mail. yes, it was there, but no attachments? Sorry to be a pain but so looking forward to seeing yours:hug:

 

[jcs]

Hey conny,
You have some good ideas there!
So afraid of getting sued, just want to cover as much as I can get away with without going way over the top as i obviously did above lol. I am sure I will eventually get something i am comfortable with soon xx

 

[geeg]

Hi Geeg
Just checked junk mail. yes, it was there, but no attachments? Sorry to be a pain but so looking forward to seeing yours:hug:

Please pm me again with your email as I have now deleted all the requests thinking I had made the attachment!!!!!! Can't believe I have done that so anyone else that got their email w/o the attachment ... you will have to pm me again with the request. xx

 

[geeg]

If you email me, I will be very glad to send you my consultation (which half the world uses now lol)! Or pm me for it but remember to include your email address.

Sorry you have binned all your work. Some of it was relevant such as the space for parental signature for youths which I would add to mine now rather than creating a separate form. Thanks for taking it so well :hug: you know me ... I have to say it even if some don't want to hear it.

A consultation form should be designed to help you to understand what a client does with her HANDS. High activity, low activity, hobbies, life style, her preference for nail style and length etc so that you can design a service you both agree on.

A good nail technician is prescriptive. We shouldn't be making 'cookie cutter' nails that are the same for every client. Both you and the client should agree on the appropriate length, shape and service and the form you designed didn't tell you any of that.

all of you who pm'd me with your email details need to do it again. If you have received an email without an attachment. Please pm me again with your email as I have now deleted all the requests thinking I had made the attachment!!!!!! Can't believe I have done that so anyone else that got their email w/o the attachment ... you will have to pm me again with the request. xx

 

[jcs]

I would not expect anyone to admit to a transferable disease Conny but the point is I have asked the question. That is my way of thinking anyway. Yes, I would sign the above I think if you have not got any problems mentioned on the form it is not a problem. The question is would it affend those who have? xx

 

[jcs]

Apologises!
Have got my wires crossed between another post. Please ignore my last comment Conny xx

 

[Conny]

I would not expect anyone to admit to a transferable disease Conny but the point is I have asked the question. That is my way of thinking anyway. Yes, I would sign the above I think if you have not got any problems mentioned on the form it is not a problem. The question is would it affend those who have? xx

Is there a law in the UK that makes it a must to let your clients sign such a questionairy?
If there is, i'm sure the clients will not be affended because they are used to it.