Indulgence Beauty | Consultation Form
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Consultation Form

If you are booking a treatment for the first time at Indulgence Beauty Salon then you may wish you fill out the Client Consultation form below and email it to us. Alternatively you can fill out the form when you arrive at the salon for your first treatment (kindly arrive 15 minutes early for your first treatment with us).

Fields marked * are required.

Personal Details











Medical History


 Yes No



 Yes No



 Yes No



 Cancer Had Cancer in the last 5 years Diabetes High Blood Pressure Low Blood Pressure Arthritis Herpes Frequent Cold Sores HIV / AIDS Hepatitis Skin Disease Skin Lesions Seizure Disorder Hormone Imbalance Thyroid Imbalance Blood Clotting Liver / Kidney infection Any active infection Any Cuts or Abrasions Open Wounds Scar tissues Varicose veins



 Roaccutane Accutane Birth Control Pills Hormones Other




 Yes No


Allergies


 Tint Latex Cosmetics Massage Oils Wax Cosmetics Aspirin Lashes Other


Skin Care History


 Yes No


 Yes No


 Yes No



 Yes No



 Yes No


 Yes No


 Tinting HD Brows BD Brows Express & semi-permanent lashes Cluster Lashes LVL Lashes

Please agree to the terms and conditions below *

I certify that the preceding medical, personal and skin history statements are true and correct.

I accept that any treatment I have is taken at my own risk. I certify that I have read and have completed the above to the best of my knowledge. I understand that failure to disclose information requested above may result in adverse side effects, unknown because of this to which I accept full liability/responsibility. I am aware that it is my responsibility to inform the Therapist of my current and ongoing medical or health conditions and it is essential for the caregiver to execute appropriate treatment procedures. I acknowledge the possible side effects of any beauty procedure.

I understand that indulgence Beauty Salon reserves the right to charge for appointments cancelled or broken without 24 hours notice.

Accept


 Yes No




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Other Indulgence Salons

Check out our sister salon in Bromley at www.indulgencebromley.com.