Beauty New Customer Registration Form

Client Details

Title: *

If Other, please specify:

First Name: *

Middle Name(s):

Last Name: *

Address: *

Postal / Zip Code: *

Email: *

Phone (Home):

Phone (Cell/Mobile): *

Date of Birth: *

How did you hear about us? *

If Other, please specify:

How would you like us to contact you? *

Phone Text Email Mail

Photography

Please tick the relevant boxes if you give us permission to take photographs of your treatment(s) / service(s)

I give permission for my photograph(s) to be used within the salon for display / educational purposes I give permission for my photograph(s) to be used within other printed publications I give permission for my photograph(s) to be used on the salon's social media pages / website

Client Signature: *

Tap or click on the signature above to sign

Appointment Guidance

If you have tested positive for COVID-19, or have any symptoms of COVID-19 (see below) please do not attend your appointment. Please contact us as soon as you know you will be unable to attend so we can reschedule.

COVID-19 Symptoms:

a high temperature or shivering (chills) – a high temperature means you feel hot to touch on your chest or back (you do not need to measure your temperature)
a new, continuous cough – this means coughing a lot for more than an hour, or 3 or more coughing episodes in 24 hours
a loss or change to your sense of smell or taste
shortness of breath
feeling tired or exhausted
an aching body
a headache
a sore throat
a blocked or runny nose
loss of appetite
diarrhoea
feeling sick or being sick