Medical History

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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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
SUBMIT

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