Consultation Card

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Your Details

Your Skin

What skincare products are you currently using?

Capillary Activity

Exfoliation history

Moisture Hydration

Oil Secretion

Nerve Activity

Female Clients

Male Clients

I hereby declare the above information is completely accurate and I have not withheld any known information pertaining to the above questions


I understand and acknowledge that payments for the above procedures are non- refundable. I confirm the procedure has been explained to me and I will hold Cosmetology harmless from any liability that may result from this treatment, in particular I acknowledge that Cosmetology their staff, or consultants will not, to the extent permitted by law, accept liability or responsibility for injury and/or damage to any person or property of any nature whatsoever whether arising from negligence or any other cause howsoever which is suffered by the Client undergoing the above procedures. In addition to the aforegoing I further acknowledge that Cosmetology will not be liable for any lack of desired results which may arise due, my failure to follow the stipulated program and home care advice. Any recommendations for treatments accepted by the client are accepted entirely at the clients risk. By my signature below, I certify that I have read, agree, and fully understand the contents of this consent form for skin care procedures, and that the disclosures referred to herein were made to me.