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PRE & POST TREATMENT CARE
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CONSULTATION FORM
First name
Last name
Email
Phone
Birthday
Day
Month
Year
Address
Treatment - please select all that apply:
Lash/Brow Tint
Waxing
Facial
Microneedling
Makeup
Hair Styling
Ear Piercing
Spray Tan
General Health - Please tick any that apply:
Pregnant
Breastfeeding
Diabetes
Autoimmune conditions
Heart conditions
Epilepsy
Blood thinners
Keloid scarring
Skin conditions (eczema, psoriasis, dermatitis)
Active acne
Cold sores
Allergies
Medications
None of the above
Contraindications - Tick any that apply:
Retinol/Vitamin A use (within 48 hours)
Accutane use
Recent chemical peel (within 2 weeks)
Recent laser treatment
Recent injectables (within 2 weeks)
Recent sunburn
Skin thinning
Varicose veins (legs)
Open wounds or skin infections
Severe sensitivity or rosacea flare
Allergies to skincare ingredients
None of the above
For facials and microneeding only - please state: What are your main skin concerns? What would you like to achieve today?
Client Goals
Consent & Acknowledgement (Please tick all of the below to agree prior to receiving our services). I confirm that the information provided is true and complete. I understand that:
*
Treatments may involve temporary redness, irritation, sensitivity, or discomfort.
Results vary depending on individual skin type and conditions.
I must follow aftercare instructions to minimise risks.
The Skin & Beauty Co. may decline treatment if contraindications are present.
Microneedling may cause redness, tightness, or sensitivity for 24–72 hours.
Waxing reactions may occur if I have used retinol, Accutane, or had recent sun exposure.
I will read/I have read the pre and post treatment information on the website or from the booking link prior to treatment?
*
I give permission for The Skin & Beauty Co. to perform the selected treatment(s).
*
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