Aesthetic Consultation Form Template UK

The Aesthetic Consultation Form Template UK is offered in multiple formats, including PDF, Word, and Google Docs, featuring customizable and printable examples.


Sample

Aesthetic Consultation Form Template UK

Editable – Printable



Aesthetic Consultation Form Template UK

1. Client Information




2. Medical History

3. Previous Treatments

4. Reason for Consultation

5. Aesthetic Goals

6. Skin Type and Sensitivity

7. Photos and Documentation

8. Consent for Treatment

9. Client Responsibilities

10. Practitioner Responsibilities

11. Refund and Cancellation Policy

12. Signature and Agreement

13. Declaration and Signatures




PDF


WORD

Examples


Aesthetic Consultation Form Template UK (1)
Patient Information:
[Patient’s Full Name]
[Patient’s Date of Birth]
[Patient’s Address]
[Patient’s Phone Number]
[Patient’s Email Address]
Consultation Date:
[Date of Consultation]
Medical History:
Please provide any relevant medical history including allergies or ongoing conditions: [Details].
Current Medications:
Please list any medications you are currently taking: [Medication List].
Reasons for Consultation:
Please specify your aesthetic concerns and desired outcomes: [Details].
Previous Aesthetic Procedures:
Have you had any aesthetic treatments before? If yes, please provide details: [Details].
Consultation Objectives:
What are your goals for this consultation? [Details].
Consent:
I understand that the consultation is for informational purposes and does not obligate me to undergo any treatments. [Signature of the Patient] [Date].
Aesthetic Consultation Form Template UK (2)
Patient Information:
[Patient’s Full Name]
[Patient’s Date of Birth]
[Patient’s Address]
[Patient’s Phone Number]
[Patient’s Email Address]
Consultation Date:
[Date of Consultation]
Medical Conditions:
Please list any medical conditions that may affect treatment: [Conditions].
Allergies:
Do you have any allergies? If so, please specify: [Allergy Details].
Expectations:
What are your expectations from the treatment? [Details].
Previous Treatments:
Please outline any previous aesthetic treatments received: [Details].
Vision of Results:
Please describe the results you hope to achieve: [Details].
Patient Declaration:
I confirm that the information provided is accurate and complete to the best of my knowledge. [Signature of the Patient] [Date].

Printable



Aesthetic Consultation Form Template UK