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Client Consultation Form for Nail Tech

Gather each client's health history, preferences, and needs before a manicure or pedicure appointment.

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Client's Name*

First Name

Last Name

Phone No*

Email*

Date of Birth*

Address

Street Address

City

State / Province

ZIP / Postal Code

Select an appointment below

Date

Time

Services you would like*

Manicure Pedicure Gel polish Nail art Nail extensions

Current Health Conditions: (Please select below)*

Diabetes Skin condition Nail fungus Pregnancy None

Do you have any allergies?*

Yes No

Please list below the type of allergies that you have

Are you currently taking any medications?*

Yes No

Please list them below including vitamins and supplements

Are you wearing gloves if you clean the house, do the gardening, or washing dishes?*

Yes No Sometimes

How do you take care of your hands?*

How do you take care of your feet?*

Are you currently using or applying products to your nails? If yes, please list the name of the products below*

When is the last time you had a professional nail service?*

How often do you go to a nail salon?*

Nail condition*

Healthy Dry Brittle Damaged

Cuticle condition*

Healthy Dry Overgrown Damaged

Do you have any cuts or wounds in your hands or feet?*

Yes No

Are you preparing for a special occasion?*

Yes No

NOTES or Anything else I should to be aware of

Terms and Conditions

Client Signature*

Sign here

Date Signed*

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