All Beauty Consent | Beauty Habitz

1. Client Details

Full Name *

Phone *

Email *

Date of Birth *

Address

2. Emergency Contact

Name

Phone

3. Medical History & Allergies

Do you have any of the following? (Please tick)

Medical history & allergies

Penicillin allergy (anaphylaxis) Tramadol allergy Other allergies (please specify) Skin conditions (e.g. eczema, psoriasis, rosacea) Currently pregnant or breastfeeding Other (please specify)

Other allergy details

Other details

4. Medications & Health

Are you currently taking any medications or supplements? *

Yes No

If yes, please list

Have you had any recent medical procedures or surgeries? *

Yes No

If yes, please specify

5. Treatment / Service Selection

Please tick all that apply

6. Important Information

Please inform me of any changes to your health, medications or skin condition.
I understand that some treatments may not be suitable if I am pregnant, breastfeeding or have certain medical conditions, and I will disclose this information before treatment.
I understand that results can vary between individuals.

7. Consent

I have read and understood the information above and I give consent to receive the selected treatments.
I understand the risks, benefits and aftercare requirements and agree to follow the aftercare advice provided.

Consent & Signature

I have read and accept the treatment consent above. I have read the privacy collection notice and understand how my information will be handled.

Client signature *

When submitted, the form version, answers, signature, timestamp and evidence checksum are stored as a locked consent record.