The Facial Consultation Form Template UK is offered in multiple formats, including PDF, Word, and Google Docs, featuring customizable and printable examples.
Facial Consultation Form Template UK Editable – PrintableSample
Facial Consultation Form Template UK 1. Client Information 2. Address Information 3. Medical History 4. Current Skincare Regimen 5. Skin Concerns and Goals 6. Consent for Treatment 7. Signature Acknowledgment 8. Adverse Reactions 9. Terms and Conditions 10. Client Preferences 11. Declaration and Signatures
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[Client’s Name]
[Client’s Date of Birth]
[Client’s Phone]
[Client’s Email]
[Date of Consultation]
Please provide details of any medical conditions, allergies, or medications you are currently taking:
[Choose: Oily, Dry, Combination, Sensitive]
Please indicate any specific concerns you wish to address:
[Options: Acne, Aging, Texture, Pigmentation, Redness, Other (please specify)]
Have you had any facial treatments before? If yes, please provide details:
[Description of previous treatments]
What are your goals for this facial consultation?
[Client’s goals and expectations]
I confirm that the information provided above is accurate and complete to the best of my knowledge and I consent to the treatment.
[Client’s Signature]
[Date]
[Client’s Name]
[Client’s Date of Birth]
[Client’s Phone]
[Client’s Email]
[Date of Consultation]
Please list the skin care products you currently use:
[List of products]
Please indicate any allergies to skincare products or ingredients:
[Client’s allergy information]
What type of facial treatment are you interested in?
[Options: Hydrating, Exfoliating, Anti-Aging, Acne Treatment, Other (please specify)]
What results do you expect from this treatment?
[Description of expected results]
In case of any issues, please provide an emergency contact:
[Contact Name, Phone Number]
I hereby consent to the facial treatment and affirm that I have provided accurate information above.
[Client’s Signature]
[Date]
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