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Client Consultation Form
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Please fill in the consultation form before your appointment.
Personal Information
Full Name
Email
Birthday
Phone Number
Full Address & Postcode
Health History
Please disclose all health related history and issues including surgeries, implants and current medical conditions
Please disclose all allergies, any mediation that you are currently taking and history or impants, botox, or collagen
Please disclose any other information which may be relevant to your treatment.
Date of submission
I confirm that I have disclosed all information regarding my health history and I have not witheld any information which may be relevant to my treatment.
Submit
Thank you. We hope you enjoy your treatment
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