Client consent and health-history form for a beauty/personal-appearance treatment — a de-facto requirement of public liability/treatment-risk insurance, with additional state-specific infection control obligations for skin penetration procedures (see the separate skin penetration compliance pack).
⚠️ This is a blank template, not legal advice: check the wording with a lawyer and adapt it to your jurisdiction and your case.
This template has no optional clauses: the text is the same for everyone. Field placeholders are shown as labels — on the site the template is read-only, values are entered inside the system.
CLIENT CONSENT FORM — BEAUTY TREATMENT
Salon / business name Client: Client name, date of birth Client date of birth. Parent/guardian consent (if under 18)
1. TREATMENT 1.1. Treatment to be performed: Treatment.
2. HEALTH HISTORY 2.1. Health history: allergies, skin conditions, pregnancy, medications 2.2. This health information is collected only for the purpose of safely delivering your treatment and will be handled in accordance with our privacy policy.
3. RISKS 3.1. Risks explained to client 3.2. I confirm the risks associated with this treatment have been explained to me and I have had the opportunity to ask questions.
4. PATCH TEST 4.1. Patch test date & result (colour/lash treatments)
5. PHOTOGRAPHY 5.1. Consent to before/after photographs: Consent to before/after photos.
6. CONSENT 6.1. I confirm the above information is accurate to the best of my knowledge, and I consent to the treatment described above.
⚠️ For skin penetration procedures (e.g. piercing, microneedling), additional state/territory infection control and registration requirements apply — see the separate Skin Penetration / Infection Control Compliance Pack.
Client signature ______________ / Client name / Date: Client signature date
— — — ⚠️ This is a boilerplate template, not legal advice. Australian workplace, consumer-protection, food safety, and work health & safety law combines uniform federal rules (Fair Work Act 2009, the National Employment Standards, the applicable Modern Award, the Australian Consumer Law) with state- and territory-specific rules that this template flags with ⚠️ but does not resolve for you — have it reviewed and adapted by a lawyer before use, check the current Fair Work Ombudsman resources at fairwork.gov.au (including free official templates and the P.A.C.T. pay calculator), and confirm the Modern Award classification and minimum pay rate in force on the date of use (rates change every 1 July).
Fields that belong to a switched-off clause are dimmed — they are not asked for.
Health information collected here is "sensitive information" under the Privacy Act — cross-reference the salon's privacy policy
Required for hair colour and lash/brow tint services to check for allergic reaction
1 of 10 fields are taken from the company, employee or counterparty record, the questionnaire can be dictated to the AI, and the finished document comes with a number, a PDF and an acknowledgement record.