• Client Record

    To be filled in by the Client
  • Today's Date*
  • Have you checked the clients' medical history and discussed any relevant information?*
  • Have you taken a BEFORE photograph?*
  • Is this the first procedure for this treatment*

  • Section 1

    To be completed by the specialist

  • Section 2

    Complete if you have had this procedure with another clinic
  • Were you happy with the outcome?*
  • Did the area heal as described?*
  • Did you experience any problems?*
  • Is there any change to the clients medical history?*

  • To be completed before commencing treatment

    Completed by the specialist

  • IF YOU ANSWERED 'YES' TO ANY QUESTIONS:

  • I understand the importance of providing an accurate and complete medical history and that withholding any medical conditions may be detrimental to my health and the outcome of the procedure. I understand that there are no guarantees as to the success or longevity go my treatment. My technician has explained the treatment and I fully understand the process. I have been given aftercare instructions and I understand that I must adhere strictly to these instructions. I accept these terms and hereby give my written consent for a trained specialist to carry outage courses treatment of my choice*
  • Client Signature*
  • Technician Signature*
  • Today's Date*

  • At the end of the Treatment

    Completed by the specialist after the procedure
  • Aftercare Advice received written and verbal*
  • Suggested next appointment timescale*

  • My procedure has been completed to my satisfaction and I have been given the opportinity to discuss any immediate concerns with my specialist. I fully understand my aftercare instructions.

  • Client Signature*
  • Technician Signature*
  • Today's Date*

  • Recorded Documentation

    Completed by the specialist after the procedure
  • BEFORE - Treatment *
  • BEFORE - Treatment
  • BEFORE - Treatment
  • MARK UP *
  • MARK UP
  • AFTER - Treatment*
  • AFTER - Treatment
  • AFTER - Treatment
  • Should be Empty: