Dee’s Beauty – Client Consultation & Consent Form

This consultation form is designed to help ensure treatments are carried out safely and appropriately. Please provide accurate and complete information. All information is kept confidential.

Client Details

Full Name		Date of Birth
Mobile Number		Home Number
Email Address		Emergency Contact
Address

Health Questionnaire

Please tick all that apply:

Diabetes	High / Low Blood Pressure	Asthma
Epilepsy	Thyroid Disturbances	Bruise / Bleed Easily
Scar Easily	Healing Problems	Stroke
Claustrophobia	Cancer	Chemotherapy
Radiotherapy	Autoimmune Condition	Skin Sensitivity
Fragile / Sensitive Nails	Eczema / Psoriasis / Dermatitis	Nail / Fungal Infections
Cuts / Open Skin	Retina A (within 6 months)	Roaccutane (within 6 months)
Botox / Fillers / Collagen Injections	Contact Lens Wearer	Sunbed User
Smoking	Allergies / Sensitivities	None of the Above

Other medical conditions or concerns:

Additional Health Information

Are you currently pregnant?	YesNo
Are you currently taking medication?	YesNo
Are you currently under GP or hospital care?	YesNo
Have you had any operations within the last 12 months?	YesNo
Do you have concerns regarding skin, nails, healing, circulation, or sensitivity?	YesNo

If YES to any of the above, please provide details:

Please list any medications taken within the last 12 months:

Treatment Consent

• I confirm that the information provided is accurate and complete to the best of my knowledge.

• I understand that failure to disclose relevant medical information, medication, allergies, or contraindications may affect treatment suitability or results.

• I understand that some treatments may cause temporary redness, irritation, or sensitivity.

• I understand that results and reactions vary between individuals.

• I understand that the therapist reserves the right to refuse or modify treatment for safety reasons.

• I consent to the treatment(s) being carried out.

Client Signature		Date
Print Name

GDPR & Data Protection

Dee’s Beauty collects and stores personal information for consultation, treatment, insurance, safety, and business record purposes only.

The following information may be held:

• Consultation Forms

• Contact Details

• Appointment History

• Treatment Records

All information is stored securely and handled in accordance with UK GDPR and data protection regulations.

Your information will not be shared with third parties unless legally required or necessary for insurance purposes.

Preferred method of communication:

TextEmailPhone

Client Signature		Date
Print Name

Photography & Treatment Records

Please tick your preferences below:

I consent to photographs being taken for treatment records and insurance purposes only.

I consent to photographs/videos being used for Dee’s Beauty social media, website, and marketing purposes.

I do not consent to photographs/videos being taken or used.

I am happy for before-and-after photographs of treatments such as nails, brows, lashes, eyes, hands, or feet to be used provided my face is not identifiable.

I understand that I may withdraw marketing/social media consent at any time by notifying Dee’s Beauty in writing.