NAIL SALON CONSENT FORM NAIL SALON CONSENT FORM

By signing below, you confirm that you have provided accurate and
current information on this form. I affirm that I have made this consent
and waiver voluntarily. In any case that I decide to withdraw or revoke
my waiver, I may do so by submitting a written request signed by me to
the salon company.
By signing below, you confirm that you have provided accurate and
current information on this form. I affirm that I have made this consent
and waiver voluntarily. In any case that I decide to withdraw or revoke
my waiver, I may do so by submitting a written request signed by me to
the salon company.

Name: ________________________________________ Name: ________________________________________

Age:______________ Temperature:____________ Age:______________ Temperature:____________

Email Address: _________________________________ Email Address: _________________________________

Mobile Number: _______________________________ Mobile Number: _______________________________

Please tick and explain the details relevant to you: Please tick and explain the details relevant to you:

___ Allergies ___ Asthma ___ Skin Cancer ___ Allergies ___ Asthma ___ Skin Cancer

___ Liver Problems ___ Skin Conditions ___ Plastic Surgery ___ Liver Problems ___ Skin Conditions ___ Plastic Surgery

___ Pregnant/Breastfeeding ___ Medication ___ Pregnant/Breastfeeding ___ Medication

___ Medical Skin creams ___ Diabetic ___ Medical Skin creams ___ Diabetic

Explanation: Explanation:
_______________________________________________________________ _______________________________________________________________
_______________________________________________________________ _______________________________________________________________

Signature ______________________ Signature ______________________

Date __________________________ Date __________________________

Thank you for taking the time to complete this form. If any of the above Thank you for taking the time to complete this form. If any of the above
information changes, please inform us immediately. information changes, please inform us immediately.

NAIL SALON CONSENT FORM NAIL SALON CONSENT FORM

By signing below, you confirm that you have provided accurate and
current information on this form. I affirm that I have made this consent
and waiver voluntarily. In any case that I decide to withdraw or revoke
my waiver, I may do so by submitting a written request signed by me to
the salon company.
By signing below, you confirm that you have provided accurate and
current information on this form. I affirm that I have made this consent
and waiver voluntarily. In any case that I decide to withdraw or revoke
my waiver, I may do so by submitting a written request signed by me to
the salon company.

Name: ________________________________________ Name: ________________________________________

Age:______________ Temperature:____________ Age:______________ Temperature:____________

Email Address: _________________________________ Email Address: _________________________________

Mobile Number: _______________________________ Mobile Number: _______________________________

Please tick and explain the details relevant to you: Please tick and explain the details relevant to you:

___ Allergies ___ Asthma ___ Skin Cancer ___ Allergies ___ Asthma ___ Skin Cancer

___ Liver Problems ___ Skin Conditions ___ Plastic Surgery ___ Liver Problems ___ Skin Conditions ___ Plastic Surgery

___ Pregnant/Breastfeeding ___ Medication ___ Pregnant/Breastfeeding ___ Medication

___ Medical Skin creams ___ Diabetic ___ Medical Skin creams ___ Diabetic

Explanation: Explanation:
_______________________________________________________________ _______________________________________________________________
_______________________________________________________________ _______________________________________________________________

Signature ______________________ Signature ______________________

Date __________________________ Date __________________________

Thank you for taking the time to complete this form. If any of the above Thank you for taking the time to complete this form. If any of the above
information changes, please inform us immediately. information changes, please inform us immediately.