Client Consultation Form | MaleMaintenanceDevel

CLIENT INFORMATION

Please complete the form below before your appointment so we can ensure treatment is safe and appropriate for you.

First name

Last name

Phone

Date of Birth

Day

Month

Year

Address

MEDICAL HISTORY

Other medical condition or relevant details

MEDICATIONS (tick all that apply)

If yes to any above, please provide details:

PREGNANCY

I am pregnant

I am not pregnant

CLIENT ACKNOWLEDGEMENT & CONSENT

This information helps us ensure your treatment is safe and tailored to you.

Please read carefully before proceeding:

• I confirm that the information provided is accurate and complete to the best of my knowledge.

• I understand that waxing may cause temporary redness, swelling, tenderness, minor bruising, ingrown hairs, or skin lifting.

• I understand that results may vary depending on hair type, skin condition, and aftercare.

• I confirm that I have disclosed all relevant medical conditions, medications, and skin sensitivities.

• I understand that failure to disclose relevant information may increase the risk of adverse reactions.

• I agree to follow all aftercare advice provided to minimise the risk of irritation or infection.

• I understand that no guarantee has been made regarding treatment results.

I confirm that I have read and understood the information above and give my informed consent to the treatment.

Do you consent to photographs being taken for treatment records? (Optional)

Full Name (Digital Signature)

Enter your full name

Date of Consent