LYMPHATIC DRAINAGE & BODY SCULPTING

  • LYMPHATIC DRAINAGE & BODY SCULPTING

    CONSULTATION FORM
  • Date of Birth*
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  • How did you hear about me?

  • Medical & Health Screening

  • Are you currently pregnant or trying to conceive?*
  • Have you given birth within the last 6 months?*
  • Do you currently have, or have you previously been diagnosed with, any of the following? (select all that apply)*

  • Contraindications

  • Do you currently have any of the following?*

  • Lifestyle & Aftercare Awareness

  • Do you drink at least 1.5L of water daily?*
  • Are you currently exercising regularly?*
  • Are you aware that lymphatic drainage works best when combined with good hydration, movement and healthy lifestyle habits?*

  • Treatment Goals

  • Are there any specific areas you would like us to focus on during your treatment? (select all that apply)*

  • Important Information

  • Please read carefully and tick the box to agree*
  • I consent to before and after photos being taken for treatment tracking and marketing purposes*
  • Date
     - -

  • Your personal information will be collected and stored securely for the purpose of providing safe and appropriate body sculpting and lymphatic drainage treatments. Your details will remain confidential and will not be shared with third parties unless required by law.


    By signing this form, you confirm that the information provided is accurate and you consent to FG Sculpt storing and processing your data for treatment purposes.

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