Luxury beauty treatments in the heart of London
Luxury beauty treatments in the heart of London
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TREATMENTS
Packages
Lashes
Facials
Permanent Makeup
Brows
BRIDAL
ABOUT US
CONTACT
BOOK
Thanks for booking your Vitamin C, LVL & Brow Lamination treatment with us!
Please fill in the form below
Your Details
Date of birth
Your Doctor's Details
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Consultation questions
Currently, are you:
Undergoing medical treatment
Yes
No
Taking any over the counter/prescription medication or herbal/natural remedies on a regular basis.
Yes
No
A smoker?
Yes
No
Pregnant?
Yes
No
Breastfeeding?
Yes
No
Using contact lenses?
Yes
No
Please indicate if you have (or have had) any of the following:
Allergies
Alopecia/hair loss
Blepharitis
Cataracts
Conjunctivitis
Contagious disease
Diabetic retinopathy
Dry eye syndrome
Eczema
Eye infection/cyst/stye
Glaucoma
Hay fever
Hives
Hormone imbalances
Hypersensitive skin
Lice
Menopause
Psoriasis
Recent body treatment
Rosacea
Sensitive eyes
Seizures
Skin or eyelid infection/disorder
Trichotillomania
Weak/brittle lashes
None of the above
Do you:
Have any known allergies including topical anaesthetics, nuts and/or metals?
Yes
No
Regularly tan in the sun/use a sunbed?
Yes
No
Suffer from cold sores?
Yes
No
Have claustrophobia?
Yes
No
Have epilepsy?
Yes
No
Or have you had reactions to facial treatments or products?
Yes
No
Have You Had:
Brow/Lash treatment previously
Yes
No
Exposure to direct sunlight or used a tanning bed in the past 24 hours?
Yes
No
If you have answered yes to any of the previous questions, please give details here.
Skin questions
What are your main skin concerns? Tick all that apply.
Acne
Large pores
Acne scarring
Dehydrated skin
Cysts/nodules
Age spots
Oily skin
Melasma
Redness
Dull complexion
Blackheads
Excessive facial hair
Rosacea
Body acne
Rough/uneven skin texture
Milia
Sun damage
Frequent breakouts
Hyperpigmentation
Other
How would you describe your skin?
Oily
Dry
Sensitive
Combination
How would you describe your stress levels?
Minimal
Moderate
High
Severe
What skincare products are you currently using?
Cleanser
Toner
Moisturiser
Facial oil
Serum
SPF
Eye cream
Exfoliating scrub
Self tan
Enzymes
Makeup
Acids/peels
Consent Agreement
I give my consent for the following treatment, Vitamin C Superfacial, LVL & Brow Lamination to be performed by AA BEAUTY. I consent that I am over the age of 18.
I understand the treatment procedure and benefits of it. I understand there are reasons I cannot have this treatment performed on me, including but not limited to diabetes, cancer, active acne, a history of bleeding disorders and the innability for blood to coagulate following an injury and sunburnt/windburnt skin, therefore I have disclosed everything in this form.
I understand that certain medications such as blood thinners, higher doses of aspirin and (ro)Accutane/isotretonoin are contraindicated for this treatment due to the possibility of nicks and cuts. I certify that I am not taking any of these medications or experiencing any of the above conditions.
I understand this treatment involves the use of a sterile, surgical blade to remove dead skin cells and vellus hair. As with the use of any sharp instrument there is a possibility of nicks and cuts however while every precaution is taken, I understand the risks.
I hereby authorise the fully trained and certified Nouveau Lashes and London Brow Company technician, Alexandra, to perform treatment upon me. I understand that it is not the responsibility of the technician to diagnose a client's susceptibility to allergies.
I accept full responsibility for determining the treatment outcome (which may include decisions regarding the degree of lash curl, length, colour, brow thickness and shape). This has been agreed during the course of my consultation.
I understand that for LVL and Brow Lamination, I will be offered a patch test which is required to be completed at least 48 hours prior to appointment and if I choose to not undertake it and go ahead with the treatment I accept all responsibility and accept all risks.
I have read and understand the aftercare given to me and realise that I am responsible for the general care of my lashes.
LASH EXTENSION MAINTENANCE: I understand that maintenance procedures are required to keep lashes looking thick, full and conditioned. I am aware that I will be charged an additional fee for any further work.
LASH REMOVAL REQUIREMENTS: I understand that Nouveau Lashes lash extensions may be professionally removed at the salon at which they were applied or removed at home using Nouveau Lashes Lash Extension Remover.
BROW LAMINATION MAINTENANCE: I understand that I am required to use a brow conditioner daily to keep by brows from drying out.
I consent to Alexandra collecting, retaining and processing medical and health information provided on this form for the purpose of my treatment, any aftercare and any other matters relating to the treatment arising after my treatment.
I confirm I have read and understood the above
Signature
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Client Declaration Date
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