Enhanced Cosmetics | Client Consultation Form

Welcome!

Thank you for choosing Enhanced Cosmetics for your treatment. Please complete this form carefully and honestly before your appointment.

Once complete, Denise will review your form and send the sensitivity patch test (where applicable), which must be completed at least 24 hours before treatment.

Denise x
Enhanced Cosmetics, Milton Keynes

Your Procedure

Step 1 of 12

I am having the following procedure carried out: *

Permanent Eyebrows (PMU Brows) Lip Blush Permanent Eyeliner Scalp Micropigmentation (SMP) Laser Tattoo Removal

Please select a service

Personal Details

Step 2 of 12

First Name *

Last Name *

Date of Birth *

Address (including postcode) *

Email Address *

Mobile Number *

Your Doctor / GP Name

Surgery Name and Address

Emergency Contact Name & Relationship *

Emergency Contact Phone Number *

Medical Health

Step 3 of 12 — Medications & Recent Substances

Please list all medications taken in the last 6 months (including over-the-counter, supplements, and herbal remedies). Type 'None' if not applicable.

Have you taken any of the following in the last two days? (tick all that apply)

Aspirin Ibuprofen Coumadin / Warfarin Alcohol Other blood-thinning medication

Have you received any of the following in the past 12 months? (tick all that apply)

Chemotherapy Radiotherapy Immunosuppressive therapy

Medical Conditions

Step 5 of 12 — Please take your time

Please tick any medical conditions that apply to you (past or present). Leave blank if none apply.

If you ticked any conditions above, please provide further details:

Previous Treatments

Step 6 of 12

Have you ever had any of the following? (tick all that apply, leave blank if none)

If you ticked any of the above, please provide additional details (dates, locations, etc.):

Procedure Details

Step 7 of 12 — Specific to your treatment

Important Information

Step 8 of 12 — Risks, Pre-care & Aftercare

Anaesthetic Consent

Step 9 of 12

A topical anaesthetic will be applied to numb the skin before your treatment. It is applied to the surface, not injected. The effects vary from person to person. Denise cannot guarantee you will not experience discomfort and cannot be held liable if the area does not numb.

Please be aware:

Allergic reactions can occur. If you experience a reaction, notify Denise immediately and contact your doctor. If severe, go to A&E.
Reactions may include redness, itching, swelling, rash, blistering, or dryness.
Swelling and redness may last 1-5 days following treatment.
For eyeliner treatments: Eyes must remain closed during numbing. If anaesthetic enters the eye, inform Denise immediately. Corneal abrasion is rare but possible.

Consent & Declarations

Step 10 of 12 — Please confirm each statement

Final Steps

Step 11 of 12 — Photo Consent & Patch Test

Photo Consent

I consent to my photographs being used on Enhanced Cosmetics' website, social media, and marketing materials. (You may decline without affecting your treatment.)

Yes No

Sensitivity Patch Test

Patch Test Instructions

The test must be completed at least 24 hours before your procedure. Non-compliance may result in rescheduling.
Place the pigment sample on one plaster and the anaesthetic on another.
Position behind each ear, top of arm, thigh, or bum. NOT in the crease of knee or elbow.
After 24 hours, remove and examine. No redness, swelling, or itching = safe to proceed.
If you experience symptoms, remove immediately, flush with cold water, and contact Denise.
The colour enclosed is for testing only. Your treatment colour will be mixed on the day.

Review & Submit

Step 12 of 12

Please review your answers before submitting. Once submitted, your form will be sent to Denise at Enhanced Cosmetics for review.

By submitting, you confirm all information provided is accurate and complete.

✓

Thank You!

Your consultation form has been submitted successfully.

Denise will review your information and be in touch regarding your sensitivity patch test and appointment details.