Beauty Medical History Form

Client Details


Medical History

Have you any history of the following conditions (past or present):


Medication / Previous treatments

Are you currently taking, or have you previously taken, any of the following medications?

Have you previously had any of the following treatments:



Declaration

I declare that the information I have provided above is correct. I will inform the salon if I develop any new medical conditions or if there is any change in my medical history.



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SUBMIT

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