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Country Beauty Client Consultation Form

Thank you for booking an appointment at Country Beauty. I look forward to welcoming you to the salon. Please take a moment to complete this form so your treatments can be safely tailored to you.


For insurance purposes, Country Beauty is an 18+ salon and treatments are available to clients aged 18 and over only.


Your comfort, safety and results are at the heart of every treatment.

Please ensure you have read and understood the booking information before proceeding.


A minimum of 48 hours’ notice is required for any cancellations or changes to your appointment.


Appointments cancelled or changed with less than 48 hours’ notice will be charged in full. This helps keep things fair for everyone and allows me to protect appointment time that’s been set aside just for you.


Appointments may be rescheduled once with more than 48 hours’ notice. Any further changes will result in the full appointment fee being charged, and a new booking will be required to secure a future appointment.


Appointments are booked based on the services selected at the time of booking. On-the-day changes may not always be possible, and removing services will still be subject to the full booking charge.

Full information can be found here:

https://www.country-beauty.co.uk/cancellation-policy

Section 1 - Client Details

Date of birth
Day
Month
Year

Section 2 - Medical Information

Do you currently have any medical conditions?
No
Yes
Are you currently under medical care?
No
Yes
Are you pregnant or breastfeeding?
No
Yes
Do you have diabetes?
No
Yes
Do you have circulatory disorders?
No
Yes
Do you have epilepsy?
No
Yes
Do you have heart conditions?
No
Yes
Do you have any skin conditions such as eczema, psoriasis or dermatitis?
No
Yes
Do you have any allergies?
No
Yes

Section 3 - Skin & Treatment Information

Have you had any recent injections (e.g. Botox or fillers) within the last 2 weeks?
Yes
No
Do you have sensitive or reactive skin?
No
Yes
Have you ever experienced a reaction to a beauty treatment or skincare product?
No
Yes
Have you had professional beauty treatments before?
No
Yes

Section 4 - Patch Testing

Some treatments require a mandatory patch test at least 24–48 hours prior to your appointment. It is your responsibility to ensure this has been completed where required.

Failure to attend or complete a required patch test will result in your appointment being cancelled and may be subject to a cancellation charge.

Section 5 - Consent to Treatment

Section 6 - Data Protection

Your personal information will be stored securely and used only for the purpose of providing safe and effective treatments. Your details will not be shared with third parties.

Have you visited Country Beauty before

Section 7 - New Client Information

As Country Beauty is a private, appointment-only salon, additional information may be required for first-time clients prior to confirming an appointment.

Section 8 - Signature

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Date
Day
Month
Year

Field Notes

Seen something you like?
Jot down treatments, products or little reminders as you explore Country Beauty. Your Field Notes will stay with you as you browse.

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