Nail Care Consultation Card

First Name

Last Name

Date of Birth

Age

Phone

Email

Address & Postcode

GP Name

GP Phone

Have you ever had a nail infection? YesNo

Have you ever had an allergic reaction? YesNo

Do you take medication? YesNo

Do you have any skin conditions pertaining to your hands or feet? YesNo

Do you have any broken skin? YesNo

Do you play any sports that take a toll? YesNo

Do you have history of picking or biting at your nails or cuticles? YesNo

Are you pregnant? YesNo

Do you smoke? YesNo

Do you do a lot of work around your home? YesNo

Do you use hand lotion? YesNo

Please Sign Here:

I have read, understood and agree with the before/after care instructions: For pedicures, please bring your flip flops. 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