Hair Removal Consultation Card

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First Name

Last Name

Date of Birth

Age

Phone

Email

Address & Postcode

GP Name

GP Phone

Have you ever had an allergic reaction? YesNo

Have you had any surgery recently? YesNo

Do you have any broken skin? YesNo

Do you have any skin conditions pertaining to area being treated? YesNo

Are you pregnant? YesNo

Please Sign Here:

I have read, understood and agree with the before/aftercare instructions: Do not exfoliate the area to be treated within 48 hours before appointment. Wear old, loose clothing to your appointment. Avoid hot, steamy environments for 24 hours including exercise. Yes

I have read, understood and agree with the COVID-19 Policy Yes

I have read, understood and agree with the Terms & Conditions Yes

I have read, understood and agree with the GDPR Privacy Policy Yes