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Elementor #7955

Consultation Form
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Name
Name (copy)
Name (copy) (copy)
HAVE YOU HAD THIS TREATMENT IN THE PAST?
IF "YES", HAVE YOU EVER EXPERIENCED ANY SKIN REACTIONS?
DO YOU SUFFER FROM ANY ALLERGIES, ILLNESSES, MEDICAL CONDITIONS OR TAKE ANY MEDICATIONS WHICH PROHIBIT YOU TO DO THIS TREATMENT?
MAY WE USE YOUR BEFORE AND AFTER FOTO FOR OUR SOCIAL MEDIA?
HOW DID YOU FIND US?
Terms of Service
YOUR SATISFACTION AND SAFETY IS OUR NUMBER ONE PRIORITY TO ENSURE YOUR
WELLBEING BEFORE, DURING AND AFTER YOUR TREATMENT, PLEASE BE AWARE OF THE
FOLLOWING INFORMATION AND POSSIBLE POINTS AS BELOW
NO WATER CAN COME IN CONTACT WITH THE EYEBROW/ EYELASHES AREA FOR 24 HOURS
AFTER THE TREATMENT (INCLUDING STEAM/SAUNAS)
THE DATA CAPTURED ON THIS RECORD CARD IS TO ENSURE OUR SPECIALISTS CAN SAFELY
PERFORM TREATMENTS ON YOU AND CONTACT YOU REGARDING YOUR APPOINTMENTS.
THE DATA WILL NOT BE SHARED WITH ANY 3RD PARTY. YOU MAY REQUEST TO
WITHDRAW CONSENT AT ANY TIME BY WRITING TO US DIRECTLY, HOWEVER, WE WILL NO
LONGER BE ABLE TO PERFORM TREATMENTS ON YOU.
I (CLIENT) WILL INFORM YOU ( JUST BROWS) OF ANY UPDATE ABOUT THE ABOVEMENTIONED DATA AND HEALTH HISTORY.