sb-salon.co.uk
07300040002
02381 22 87 86
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Sun : 10:00-18:00
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Practitioner Treatment Consent Form
Therapist Name
Alka
Priya
Seema
Eva
Leah
Location
Treatments client/i (client) receiving
Client Details:
Client/model Full Name
Email (Optional)
Contact Number (Optional)
Date of Birth
AGE
Under 16
Under 18
18 or 18+
Who was the client model arranged by?
Salon
Therapist Trainee
Is the model client/model related to trainee? if yes please indicate below:
Friend
Family
Other
No
Consent:
I, the client, confirm that I wish to undergo a beauty treatment performed by a trainee for training and practice purposes, under the supervision of an experienced therapist. I understand that, as this is part of a learning process, mistakes or reactions may occur during or after the treatment. I acknowledge that the treatment is provided free of charge, as I am participating as a model to support the trainee’s development.
Medical & Health
I have disclosed all my medical, health and treatment details with the therapist and salon which may / can affect for me to have the treatment.
Wavier:
I hearby releace fron any and all laiabltyies, reaction befroe,during and afer and any lose of for threatment performed I willingly accept and take full responsibility for any such risks. i am waving my right to sue seema's beauty salon and its employees.
Client Acknowledgement:
I hereby acknowledge that I have read, understood, and agreed to the above consent of my own free will. The information I have provided is true and accurate to the best of my knowledge. I understand that any false or inaccurate information may result in adverse reactions and may prevent any claims from being supported.
Client Before & After photos
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Client-Sign
Client Sign Date & Time
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