hi geeks,
what do you think to this? does anyone have any recommendation or think im missing anything? think the format will be a bit misread on here tho xx
Spray Tanning Consultation
Client Name: Date: Therapist Name:
Date of Birth: Allergies: Previous Tans:
----------------------------------------------------------------------------------------------------------------------------------------------------------
Skin Type:
Contra-Indications Preventing Treatment:
……………………………………………………………………………………………
……………………………………………………………………………………………
Contra-Indications Requiring Referral:
……………………………………………………………………………………………
……………………………………………………………………………………………
Necessary Action:
Encourage to seek medical advice / explain why no treatment / modification of treatment / treatment to go ahead.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Patch Test:
Patch test carried out: Yes / No
Date patch test took place:
Location of patch test:
Outcome:
-------------------------------------------------------------------------------------------------------------------------------------------------------
Treatment Plan:
Details agreed with Client
Depth of Colour:
Cost:
Duration:
Products used: Tanning Product / Moisturiser / Barrier Cream / Exfoliant.
Skin Area: Body / Face.
-------------------------------------------------------------------------------------------------------------------------------------------------------
After- Care Advice Given:
Contra-Actions Home Care Sheet / Xen-Tan After Care Sheet / Verbal advice.
The above-named therapist has:
* Explained the treatment to me and discussed my requirements, of which have been detailed on this sheet. Yes/No
* Carried out a patch test at least 24 hours before the treatment and found no problems or reaction. Yes/No
* Given me all Contra-Indications, Contra- Actions, Preperation Tips and After Care advice sheets prior to the tan application (on the day of the patch test). Yes/No
I confirm that I have read and carried out as necessary the Preparation Tips and that I have read all of the Contra-Indications, Contra-Actions, Prep Tips and After Care advice sheets and have informed .....: *of the following issues/there are no issues or concerns raised.
____________________________________________________________________________________________________________
*Circle as appropriate.
I understand that should ...... be misinformed or mislead in any way that they will not be held responsible for any pre tan contra indications or any after tan contra actions.
Client Signature _________________________ Date:______________
what do you think to this? does anyone have any recommendation or think im missing anything? think the format will be a bit misread on here tho xx
Spray Tanning Consultation
Client Name: Date: Therapist Name:
Date of Birth: Allergies: Previous Tans:
----------------------------------------------------------------------------------------------------------------------------------------------------------
Skin Type:
- Skin that tans easily/ skin that does not tan easily.
- Normal / oily / dry / combination.
- Sensitive / mature / dehydrated.
- Dry Areas………………………………………
Contra-Indications Preventing Treatment:
……………………………………………………………………………………………
……………………………………………………………………………………………
Contra-Indications Requiring Referral:
……………………………………………………………………………………………
……………………………………………………………………………………………
Necessary Action:
Encourage to seek medical advice / explain why no treatment / modification of treatment / treatment to go ahead.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Patch Test:
Patch test carried out: Yes / No
Date patch test took place:
Location of patch test:
Outcome:
-------------------------------------------------------------------------------------------------------------------------------------------------------
Treatment Plan:
Details agreed with Client
Depth of Colour:
Cost:
Duration:
Products used: Tanning Product / Moisturiser / Barrier Cream / Exfoliant.
Skin Area: Body / Face.
-------------------------------------------------------------------------------------------------------------------------------------------------------
After- Care Advice Given:
Contra-Actions Home Care Sheet / Xen-Tan After Care Sheet / Verbal advice.
The above-named therapist has:
* Explained the treatment to me and discussed my requirements, of which have been detailed on this sheet. Yes/No
* Carried out a patch test at least 24 hours before the treatment and found no problems or reaction. Yes/No
* Given me all Contra-Indications, Contra- Actions, Preperation Tips and After Care advice sheets prior to the tan application (on the day of the patch test). Yes/No
I confirm that I have read and carried out as necessary the Preparation Tips and that I have read all of the Contra-Indications, Contra-Actions, Prep Tips and After Care advice sheets and have informed .....: *of the following issues/there are no issues or concerns raised.
____________________________________________________________________________________________________________
*Circle as appropriate.
I understand that should ...... be misinformed or mislead in any way that they will not be held responsible for any pre tan contra indications or any after tan contra actions.
Client Signature _________________________ Date:______________
