Client Record Form

Welcome to Gracie B, we look forward to looking after you.

Please fill in your personal details to the best of your knowledge to assist your therapist / stylist with your future treatments at Gracie B.

Please enable JavaScript in your browser to complete this form.
Name
Address
Date of Birth

 

Medical History

 

Medical History (Please tick all that currently apply)

 

Nail Treatment

If you are with us today for a nail treatment, please answer the questions below;

Describe your nails currently
Do you work with your hands at home?
Do you have a history of biting or picking your nails or cuticles?
Do you currently have gels or acrylics on the nail?

 

Disclaimer

 

I am signing to say I am going ahead with my treatment without a recommended patch test. The risk elements have been explained to me and I am happy to take liability for this.
I agree to my information being stored securely by Gracie B for the purposes of treatment