Client Consultation Form

Client's Name

First NameLast Name

Phone No

Email

Date of birth

DD-MM-YYYY

Address

Street Address

Street Address Line 2

Post Code

Select an appointment below

Services you would like

Current Health Conditions: (Please select below)

Do you have any allergies?

Please list below the type of allergies that you have

Are you currently taking any medications?

Please list them below including vitamins and supplements

Are you wearing gloves if you clean the house, do the gardening, or washing dishes?

How do you take care of your hands?

How do you take care of your feet?

Are you currently using or applying products to your nails? If yes, please list the name of the products below

When is the last time you had a professional nail service?

How often do you go to a nail salon?

Nail condition

Cuticle condition

Do you have any cuts or wounds in your hands or feet?

Are you preparing for a special occasion?

NOTES or Anything else I should to be aware of

By signing below, I confirmed that all information I entered in this form is accurate and true. I authorized this Nail Technician to perform nail care service to my hands and feet.

I agree for any photos taken during and after the treatment to be used for marketing purposes.

Client Signature

Date Signed

Date