Hello geeks, would any of you care to have a quick look at my consultation card just to check I haven't missed anything off/have anything on I don't need? I offer shellac mani's/pedi's, gel enhancements & spray tanning if that helps a little, we did them at college but they were 2 1/2 pages long and had so much info in it was just OTT. So i'm a little worried I have added with too little/too much. - it fits onto 1 A4 page.
Thank you
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 ___________________________________________
Do you suffer from any skin disorders?
If yes, please explain: _______________________________________________________________ _________________________________________________________________________________
Are you currently taking any medication, whether prescribed or over-the-counter? Yes __ No __
If yes, please explain: _______________________________________________________________ _________________________________________________________________________________
Disclaimer
I declare that all information given is correct and I have informed my therapist of accurate details to questions asked and I agree to inform my therapist of any changes.
I acknowledge that after pre-care and after-care advice should be followed and maintained, and that this is my sole responsibility to carry this out, and if any problems occur it is my responsibility once I leave the professional care of Katherine Curry.
Signature: ____________________________________________________________
Date: _______________________
Parent/Guardian (if party is a minor):
_____________________________________________________________________
(Nail Treatments Only)
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: _______________________________________________________________ _________________________________________________________________
Hobbies/Occupation:
__________________________________________________________________________________________________________________________________
(Spray Tanning Only)
Do you have any recent tattoos or body piercings? Yes __ No __
If yes, how recently? _________________________________________________________________
Could you be pregnant? Yes __ No __
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: _______________________________________________________________ _________________________________________________________________
Do you tan easily in the sun? Yes __ No __
Thank you
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 ___________________________________________
Do you suffer from any skin disorders?
If yes, please explain: _______________________________________________________________ _________________________________________________________________________________
Are you currently taking any medication, whether prescribed or over-the-counter? Yes __ No __
If yes, please explain: _______________________________________________________________ _________________________________________________________________________________
Disclaimer
I declare that all information given is correct and I have informed my therapist of accurate details to questions asked and I agree to inform my therapist of any changes.
I acknowledge that after pre-care and after-care advice should be followed and maintained, and that this is my sole responsibility to carry this out, and if any problems occur it is my responsibility once I leave the professional care of Katherine Curry.
Signature: ____________________________________________________________
Date: _______________________
Parent/Guardian (if party is a minor):
_____________________________________________________________________
(Nail Treatments Only)
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: _______________________________________________________________ _________________________________________________________________
Hobbies/Occupation:
__________________________________________________________________________________________________________________________________
(Spray Tanning Only)
Do you have any recent tattoos or body piercings? Yes __ No __
If yes, how recently? _________________________________________________________________
Could you be pregnant? Yes __ No __
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: _______________________________________________________________ _________________________________________________________________
Do you tan easily in the sun? Yes __ No __
