Facial Consent | Beauty Habitz

1. Client Details

Full Name *

Phone *

Email *

Date of Birth *

Address

What is your main skin concern? (Please tick)

Skin type

I II III IV V VI

What skincare products are you currently using?

Are you using retinol, prescription skincare or acne medication? *

Yes No

If yes, please specify

Have you had any recent cosmetic treatments or procedures? *

Yes No

If yes, please specify and where

What are you hoping to achieve from your facial?

Some treatments may not be suitable if you have certain medical conditions, are pregnant, breastfeeding or are taking specific medications.
I understand that results can vary between individuals and are not guaranteed.
I agree to follow the aftercare advice provided.

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.