My consultation cards - your opinions please!

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geekling

Well-Known Member
Joined
Jun 23, 2011
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Location
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Hi all, here is my consultation card; any feedback much apresiated!

Too much? Have I missed anything?
They are bits and pieces taken from different threads on here and different consultations cards I have seen.

I will be offering treatments such as, mani/pedi, shellac, nail enhancements, eye lash/brow tinting, facials.


Name ___________________ DOB ___________________
Contact Number ___________________
Address Email Address ___________________
___________________
___________________
___________________

Do you have any allergies? Yes __ No __
If yes, please explain: _______________________________________________________________

Do you suffer from asthma? Yes __ No __

Are you currently taking any medication, whether prescribed or over-the-counter? Yes __ No __
If yes, please explain: _______________________________________________________________ _________________________________________________________________________________

Do you have, or have you had, a history of:
Diabetes __ Heart Disease __ Thyroid Problems __ Circulatory/Muscular Disease __ Hypertension __
Cancer __ Depression __ Menopause __ Other ___________________________________________

Have you ever had a reaction to eyelash/eye brow tints?
If yes, please explain: _______________________________________________________________ _________________________________________________________________________________

Do you suffer from any skin disorders?
If yes, please explain: _______________________________________________________________ _________________________________________________________________________________

Have you ever had an allergic reaction to any type of nail enhancement or other nail related product?
Yes __ No __

If Yes, please explain: _______________________________________________________________ _________________________________________________________________________________

Are you currently taking any medication, whether prescribed or over-the-counter? Yes __ No __
If yes, please explain: _______________________________________________________________ _________________________________________________________________________________

(Nail Treatments Only)
Do you do a lot of work around your home such as cooking, cleaning, gardening, etc? Yes __ No __
If yes, please explain: _______________________________________________________________ _________________________________________________________________________________
Do you have a history of picking or biting at your nails or cuticles?
Always __ Sometimes __ Rarely __ Never __

Have you ever experienced a nail infection of any sort? Yes __ No __
If yes, please explain: _______________________________________________________________ _________________________________________________________________________________

Have you had any nail treatments/enhancements before? Yes __ No __
If yes, please explain what they were and how you found them: _____________________________
_________________________________________________________________________________





(Spray Tanning Only)
Do you have any recent tattoos or body piercings? Yes __ No __
If yes, how recently? _________________________________________________________________________________
Are you pregnant? Yes __ No __

Have you ever had a reaction to spray/self-tan products?
If yes, please explain: _______________________________________________________________ _________________________________________________________________________________

Do you have bleached or coloured hair?
Have you ever had a reaction to spray/self-tan products?
If yes, please explain: _______________________________________________________________ _________________________________________________________________________________

Do you have sensitive, broken or cracked skin?
If yes, please explain: _______________________________________________________________ _________________________________________________________________________________

(Therapist only)
Patch Test:

Product:

Date:


I _______________________ (Client) am fully aware that there are potential risks involved in receiving these services, and in the use of cosmetology products and chemicals, including but not limited to possible allergic, chemical, or other adverse reactions which might cause injury, illness or even death. Being fully aware of such possible adverse consequences, I hereby assume all risk of such injury, illness, or death and hereby release any technician/stylist of Katherine Curry from and against any and all liability for any harm, injury, illness, damage, claims, demands, actions, causes of action, costs and expenses of any nature that I might have or that may hereafter accrue to me, arising out of or related to any such injury, illness, illness or death that may be sustaned by me as a result of the services provided by any technician/stylist of Katherine Curry Further, I affirmatively state that I have no illness or health condition which might be aggrivated or otherwise adversely affected by the procedures I am obtaining from Katherine Curry.
I acknowledge that after card advice should be followed and maintained, and that this is my sole responsibility once I leave the professional care of Katherine Curry.

I declare that I am over the age of eighteen and am competent to sign this consent and release of liability form and that I execute this document freely, knowingly and voluntarily.

Signature: ____________________________________________________________
Date: _______________________

Parent/Guardian (if party is a minor):
_____________________________________________________________________




Thankyou in advance! :)
 
No offence hun I think it's too much!! Maybe have separate ones for different treatments.
You missed out are you pregnant, really important xxxx
Good questions though hub well done, the statement at the bottom is a bit long, people won't read it n you need them too!! Xxx
 
Are you pregnant is in there! I do always ask are you or could you be preganet though. Justbincase they are trying and dont wamt to say! Very informative.
Agree with above post that maybe they could be broken down to individual treatments. Well done!
 
Sorry my fault!!
 
I was going to use separate ones, but liked the idea of having just the one card for them to fill in! Maybe had the first section on 1 piece of card, the other 2 on other pieces? I just didn't want to waste client time and paper really! Haha!
I thought it looked too much that's why I added in the (Nails only) and (spray tanning only) sections! Thank you for your replies! :) xxx
 

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