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Let us do this part
Today's Date:
Mon Dec 2 2024 04:30
Welcome to Milly's Beauty Bar.

For your own safety please fill in this form as accurately as possible before your treatment. Failure in doing so may affect your final result or result into not be able to perform the treatment (this is not our responsibility). The information you provide us with will not be given or taken out of the salon.


we hope you enjoy your visit and we cannot wait to have you in the salon!
Many thanks
Love Milly and the girls <3
Please read and answer
Y
N
Do you have any known allergies?*
Details:
 
Y
N
Do you have any medical conditions that you need to disclose? *failure in doing so may affect your outcome*
Details:
 
Y
N
Are you on any medications we need to know about? ie steriod cream/ tablets, blood thinning tablets.*
Details:
 
Y
N
Are you pregnant or nursing? if so are you happy to go ahead with the treatment?*
Details:
 
Y
N
Do you feel fit and healthy to undergo your treatment?*
Y
N
Is there ANYTHING else you feel we should know before we begin?
Details:
 
 
Doctors name and surgery address*
 
Y
N
i agree to using pictures of my treatment for marketing and social media purposes*
I understand that i am required to have a skin test 48 hours prior to any tinting service and it is my own responsibility to do so*
I agree to update Millys Beauty Bar with any changes to the records and details i have given today


.
I have completed a patch test 48 hours prior to the treatment and noted no reaction, therefore I am happy to proceed with the treatment and accept full responsibility for any reaction which could Occur. I have not withheld any information regarding my health and the information I have provided is true to the best of my knowledge. I understand - as my body adjusts to the treatment provided - I may develop some minor reactions to it. I have been informed of contra indications and contra actions and I am aware that my involvement in the treatment is of my own choice.




By signing this form you agree to us holding sensitive personal data regarding bookings and treatments.
If any provision, section, subsection, clause or phrase of this release is found to be unenforceable or invalid, that portion shall be severed from this contract. The remainder of this contract will then be construed as though the unenforceable portion had never been contained in this document.
Client Information
I hereby declare that I am of legal age (with valid proof of age) and am competent to sign this Agreement or, if not, that my parent or legal guardian shall sign on my behalf, and that my parent or legal guardian is in complete understanding and concurrence with this agreement.
Name:*
Address:
Postcode:
Date of birth:*
If you are under 18 your parent/guardian will be required
Phone #:*
Email:*
Signature:*