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    Patch Test & Disclaimer

    1. Client & Appointment Details
    1.1 Therapist
    Select therapist
    1.2 Treatment Slot
    1.3 Full name *
    1.4 Treatment(s)
    Select treatment(s)
    1.5 Contact *
    1.6 Email *
    1.7 Age category *
    1.8 D.O.B (optional)
    2. Guardian / Emergency Contact (Optional)
    2.1 Name
    2.2 Contact
    2.3 Relation
    2.4 Guardian / Emergency Contact Signature *
    Required where the client is under 18 or where a guardian/emergency contact is providing consent.
    3. Treatment History & Reactions
    3.1 Had this treatment before? *
    3.2 If Yes: where did you last have it?
    3.3 Reaction to similar products/treatments? *
    3.4 If Yes: which products?
    4. Client Health Details
    4.1 Are you on any medications? *
    4.2 Health issues / skin conditions / allergies *
    4.3 Injuries / surgeries *
    4.4 Are you pregnant? *
    4.5 If you answered “Yes” to any: provide details *
    5. Patch Test, Consent & Conditions
    5.1 Patch Test Status *
    5.2 Patch Test Date
    5.3 Patch Test Time
    I confirm I have read and understood all statements in Section 5 above and I agree to them. By ticking this box, the related acknowledgements will be selected for convenience.
    I confirm I am 18+ and legally able to consent, OR if under 18 I am attending with a parent/legal guardian who has consented on my behalf.
    I understand a patch test is recommended and may be required before certain treatments (eyelash lift, eyelash extension, tint, waxing, brow lamination, henna, facial) to minimise the risk of allergic reaction.
    I understand a patch test is not always 100% conclusive and a reaction may still occur despite a negative result.
    I have informed the salon of any known allergies, sensitivities, and relevant medical conditions.
    I understand it is my responsibility to contact the salon and seek medical advice if I experience any unusual reaction following a patch test or treatment(s).
    If I experience swelling, itching/burning, redness/blistering, or difficulty breathing, I will notify Beauty Arts and contact a healthcare professional immediately (for breathing issues, I will call emergency services).
    If I choose to decline the patch test, I accept responsibility for allergic/adverse reactions that may occur. I understand the salon may refuse, reschedule, or restrict treatment for safety/insurance reasons.
    I understand I will receive a confirmation email and relevant aftercare guidance for the treatment(s). If I do not receive it before leaving, I will request another copy, or I will request a hard copy before leaving the salon.
    I will request clarification before leaving if I have any questions about aftercare advice.
    I understand aftercare is my responsibility and results may be affected if advice is not followed. I understand the salon is not responsible for adverse outcomes where relevant information was not disclosed or aftercare advice was not followed.
    I understand my information is recorded for treatment history, safeguarding, and insurance purposes, stored securely, and retained only as long as necessary.
    I confirm I have disclosed all relevant information and I will inform the salon of any changes before any appointment/treatment.
    If I choose not to provide my own email address, I authorise the salon to use a placeholder email (e.g., no-email@client.com) solely to submit and securely store this form.
    If I do not provide my date of birth, I understand age verification and safeguarding checks may be limited. The salon may request ID or refuse/restrict treatment for safety, legal, insurance, or safeguarding reasons.
    I consent to photos being taken before and/or after the patch test/treatment for record-keeping and treatment documentation (where applicable).
    We reserve the right to reschedule, refuse, or cancel any appointment/service for valid reasons including late arrivals, health/hygiene concerns, inappropriate behaviour, unsuitable client condition, or staff availability/emergencies.
    We maintain a zero-tolerance policy. Serious misconduct may be reported to the appropriate authorities and may lead to legal action.
    I confirm all information provided is true/accurate. I was advised about patch testing and risks, had the opportunity to ask questions, and I voluntarily agree to this form.
    By proceeding with this or any treatment at Beauty Arts, I confirm I have read, understood, and agree to the full Terms & Conditions.
    6. Signature
    6.1 Client signature *
    6.2 Print name *
    6.3 Staff notes

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