NAIL CARE CONSULTATION & CONSENT FORM
Please complete this form to help us provide a safe and personalized head spa and mini facial experience. Your information will remain confidential.
Client Information
Please provide your personal and contact details.
Full Name
*
First Name
Last Name
Email
*
Phone Number
*
Format: (000) 000-0000.
Date
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Month
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Day
Year
HEALTH & SAFETY SCREENING
Please answer the following:
Do you have any known allergies or sensitivities to nail products, acrylic, gel, dip powder, glue, or acetone?
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No
Yes
Details
*
Do you currently have any nail fungus, infection, cuts, swelling, bleeding, or open skin on your hands or feet?
*
No
Yes
Details
*
Do you have any medical condition that may affect your nails, skin, circulation, or healing?
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No
Yes
Details
*
Are you taking any medication or undergoing treatment that may affect your skin, nails, or healing?
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No
Yes
Details
*
Do you have any pain, tenderness, or sensitivity in the service area today?
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No
Yes
Details
*
CLIENT CONSENT
Consent
*
I confirm that the information above is accurate to the best of my knowledge. I understand that waxing may cause temporary redness, sensitivity, or irritation. I agree to inform the provider of any allergy, medication, skin condition, or discomfort before service. I understand that service may be modified, postponed, or declined if it is not safe to proceed.
Client Signature
*
Date Signed (Client)
*
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Month
-
Day
Year
Date
Submit Consultation & Consent
Submit Consultation & Consent
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