Client Treatment Consent DRIP OF BEAUTY AND WELLNESS HUB CLIENT TREATMENT CONSENT FORM Full NamePrefixSelectMr.Mrs.Ms.Dr.Prof.First Name *Last Name *Date of BirthPhone NumberEmail AddressSelect Treatment▼FACIAL TREATMENTSGLUTA DRIPSLIMMING SERVICE12D HIFUFacial Treatment Aftercare InstructionsFacial Treatment Aftercare InstructionsGLUTA DRIP — AFTERCARE INSTRUCTIONS After your treatment: Follow the aftercare instructions provided by our clinic staff. Drink fluids as recommended by your treatment provider. Follow any additional instructions provided based on your individual treatment. Inform the clinic if you experience any unexpected or concerning symptoms after treatment. If you have any concerns after your treatment, please contact our clinic.Treatment DateDo you have any allergies or sensitivities that may be relevant to your treatment? YES NOAre you currently taking any medications or supplements that may be relevant to your treatment? YES NOCLIENT DISCLOSURE I understand that I should inform the clinic of any relevant health conditions, allergies, medications, sensitivities, or previous treatment reactions. I confirm that the information I have provided is accurate and complete to the best of my knowledge.Client SignatureClearSubmit
