Advanced Facials-Sem2 Session1/Cynthia Li /2011 1

Guidelines toClient Consultation Form

1. WHAT? Client Consultation Form2. WHY? Provides an in-depth Consultation which

reveals Contraindications, Client’s current regimen & expectations of your services.

Charts Clients’ progress. Presents as a vital record of medical

conditions disclosed by Client.3. WHEN? Prior to treatment.4. WHERE? In Reception area or Treatment Room.5. HOW? Client fills/updates the Client Consultation

Form. Therapist goes over the details with the Client, asks questions for clarification & answers the Client’s questions.Ensure that Client has signed the Client Consultation Form.

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Key Sections ofClient Consultation Form

Your HealthQ1:Underlying medical reason that may affect

your treatment choice.Contact the Client’s doctor if unsure of suitability of your treatment.

Q2:Areas of recent surgery should not be massaged for at least 3 months (facial area) or 6 months (body).

Q3:Treatment should be modified if Health problems in the past or present – cancer, diabetes, epilepsy, heart problem, spinal injury hormone balance, hysterectomy, thyroid condition, varicose veins & systemic disease.

Q4:Client’s medications & vitamins can have dramatic effect on their skin – antibiotics, Herpes ointments, high blood pressure tablets, chemotherapy, cortisone, Retin-Adapalene /Renova, Accutane & prescription Benzoyl peroxide.

Q5:Smoking depletes Vitamin C, impairs healing, causes yellow/sallow skin, comedones & fine wrinkles.

Q6:Lack of exercise calls for a more detoxifying, stimulation course of treatment.

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Key Sections ofClient Consultation Form

Your HealthQ7:Highly-restricted diet/fasting can cause

breakouts, dry skin, hormonal imbalance & body hair growth.

Q8:If Client wears contact lenses, do not apply pressure on/around eyelid, or ask Client to remove them prior to treatment.

Q9:Metal implants, pacemaker & body piercings contraindicate the use of electrical current.

Q10:Treatment should be modified to Client’s stress level.

Your SkinQ11:Give client the opportunity to discuss their

skin/body problems.Q12:Clients’ general level of skin care

sophistication will be indicated by the diversity of the homecare regimen.

Exfoliation HistoryQ13:Follow the ‘Less Rule’ so as not to over-

stimulate the skin.Q14:Do not exfoliate or wax area treated by any

prescription or topical acne treatment product for at least 3 months after Client has stopped using it.

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Key Sections ofClient Consultation Form

Exfoliation HistoryQ15:Over-exfoliation can dry, over-sensitise &

cause premature ageing.Moisture HydrationQ16:Clients should consume at least 8 glasses

of plain water everyday. Q17:Consumption of more than 8 alcoholic

beverages per week can cause skin dryness & bodily dehydration.

Q18:Clients experiencing flakiness, tightlness & obvious dryness should increase their water intake.

Q19:Clients should use an SPF15 sunscreen over the face/body daily to prevent incidental sun damage.

Q20:Recommend higher SPF to sunbathing clients & Protective Self Tan/Spray tanning.

Capillary ActivityQ21-24:Can indicate possible early stages of

Rosacea, skin sensitivity/environmentally sensitised skin.

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Key Sections ofClient Consultation Form Oil SecretionQ25:Oily shine may indicate overuse of

exfoliants, dehydration & overactive sebaceous glands.

Q26:For Clients experiencing breakouts, check for comedogenic ingredients in current skin/hair/makeup regimens.

Nerve ActivityQ27:High levels of caffeine can increase skin

sensitivity & blood circulation, reduce skin moisture levels, cause anxiety & low pain threshold.

Q28:Burning & itching on the skin can be due to cosmetic allergies.

Q29:Client’s pain threshold will determine how firm you can massage, perform extractions, & the client’s response to waxing.

Q30:Clients who experience claustrophobia should not be wrapped tightly, have their arms wrapped or be left unattended during a treatment.

Q31:Client’s preferred massage pressure.Q32:If in doubt of a Client’s suitability for

treatment, perform a patch test to check for reactions – cosmetics, medicine, pollen, food, animals, Iodine, Hydroxy acids, fragrance & sunscreens.

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Key Sections ofClient Consultation Form Female Clients onlyQ33:Oral contraceptives can cause uneven skin

pigmentation, skin breakouts & dryness.Q34:If Client is pregnant/trying to become

pregnant, avoid essential oils, electrical current, high temperature & detoxifying treatments.

Q35:If Client is lactating, do not use essential oils.Male Clients onlyQ36:Identify cause of shaving irritation &ingrown

hairs. Q37:Troubleshoot shaving irritation problems by

recommending a pre-shave scrub to lift hairs & prevent ingrowns.

Q38:Recommend regular exfoliation & scrub before shaving.

Questions to discuss every visitQ39:Menstruation increases skin sensitivity.Q40:Have the returning Client check over their

previous entries on their Client Consultation Form to alert you of any new contraindications.

Q41:Dental x-rays may temporarily reduce sebaceous activity & cause skin dryness.

Q42:Discussing Client’s expectations before every treatment ensures that you tailor your service to meet their needs everytime.