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Alon Studio- Client Registration & Safety Waiver

Welcome to Alon Studio!

Getting to know you:

Full name

Date of Birth

Email address:

Contact number

Emergency Contact Name

Emergency Contact Number

Treatment

Which treatment are you booking in for

Which treatment are you booking in for

Please note: SPMU bookings will begin as soon as my council license inspection is complete—let me know if you’d like to be on the waiting list!

Please note: SPMU bookings will begin as soon as my council license inspection is complete—let me know if you’d like to be on the waiting list!

How can I make your experience more relaxing?

How can I make your experience more relaxing?

Medical History

Are you pregnant?

Are you breastfeeding?

Do you have any of the following eye conditions?

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Do you have any of the following skin conditions?

Do you have any of the following skin conditions?

Do you suffer from poor circulation?

Do you suffer from numbness or peripheral neuropathy in your hands or feet?

Do you have any blood borne pathogens?

Do you have any blood borne pathogens?
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Are you on any blood thinning medication? If yes, please state what it is:

Are you on any blood thinning medication? If yes, please state what it is:

Do you have a history of Keloid scarring?

Do you have slow wound healing?

Have you ever had a reaction to any of the following?

Have you ever had a reaction to any of the following?
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Are you currently taking or have recently used:

Are you diabetic?

If yes, is your condition currently well managed?

Diabetes type:

Do you have a history of epilepsy?

Please state anything else that we need to be aware of:

Please state anything else that we need to be aware of:

The Little Waves (Child Policy)

Are you attending with your child/children?

Your little one's name, date of birth, good to knows, fun facts:

I understand that I am 100% responsible for my child/children's safety and behaviour. I will remain in the room with my child at all times.

I understand that I am 100% responsible for my child/children's safety and behaviour. I will remain in the room with my child at all times.

I agree to keep my child/children within the designated ‘Play Zone’ and away from the ‘Treatment Zone’ (where sharp tools, hot wax and professional chemicals are used)

I agree to keep my child/children within the designated ‘Play Zone’ and away from the ‘Treatment Zone’ (where sharp tools, hot wax and professional chemicals are used)

I confirm my child/children has not had a fever, sickness bug or any contagious rash or illness (e.g Hand, Foot & Mouth, Chicken Pox etc) in the last 48 hours to protect the health of the studio and other clients.

I confirm my child/children has not had a fever, sickness bug or any contagious rash or illness (e.g Hand, Foot & Mouth, Chicken Pox etc) in the last 48 hours to protect the health of the studio and other clients.

I understand that the play zone, high chair, bouncer or any other available toys and items in the studio are used at my own risk. I will ensure my child/children uses them as intended.

I understand that the play zone, high chair, bouncer or any other available toys and items in the studio are used at my own risk. I will ensure my child/children uses them as intended.

I understand that for hygiene reasons, I must provide my own changing mat and take any used nappies back with me.

I understand that for hygiene reasons, I must provide my own changing mat and take any used nappies back with me.

I agree to clean up after my child/children at the studio to ensure the hygiene of the play zone and studio is maintained.

I agree to clean up after my child/children at the studio to ensure the hygiene of the play zone and studio is maintained.

I understand that while Alon Studio is child friendy, it is a professional environment and will do my best to manage my child/children’s noise level so the treatment can be completed safely.

I understand that while Alon Studio is child friendy, it is a professional environment and will do my best to manage my child/children’s noise level so the treatment can be completed safely.

I acknowledge that if my child requires significant attention, my treatment time may be reduced or paused. I understand that the full treatment fee still applies.

I acknowledge that if my child requires significant attention, my treatment time may be reduced or paused. I understand that the full treatment fee still applies.

I agree that for safety, no hot drinks are permitted in the play zone.

I agree that for safety, no hot drinks are permitted in the play zone.

I agree to notify, Alon, immediately of any accidents or spills caused by my child/children so they can be cleaned with clinical grade disinfectant.

To maintain a clinical and clean environment for all children, I agree that shoes must be removed before entering Alon Studio.

To maintain a clinical and clean environment for all children, I agree that shoes must be removed before entering Alon Studio.

Photos & Social Media

Model Consent:

Model Consent:

Declaration

I understand the £10 deposit is non refundable if I cancel with less than 48 hour notice.

I understand the £10 deposit is non refundable if I cancel with less than 48 hour notice.

I declare that the medical information provided is true and I have not withheld any information regarding my health or medications.

I declare that the medical information provided is true and I have not withheld any information regarding my health or medications.

I agree to follow the aftercare advice provided to me. I understand that Alon Studio is not responsible for issues caused by improper after care.

I agree to follow the aftercare advice provided to me. I understand that Alon Studio is not responsible for issues caused by improper after care.

I understand that Alon Studio is not responsible for any loss or damage to personal items or my child/children’s toys or belonging brought onto the premises.

I understand that Alon Studio is not responsible for any loss or damage to personal items or my child/children’s toys or belonging brought onto the premises.

I agree that shoes must be removed before entering Alon Studio. (Socks or indoor slippers are welcome!)

I agree that shoes must be removed before entering Alon Studio. (Socks or indoor slippers are welcome!)
Please note:
I am currently completing my degree in Podiatry. While my medical training ensures the highest standards of hygiene and sterilization in my studio, I am currently only insured and qualified for the Beauty and Aesthetic treatments listed. I am not yet a HCPC registered Podiatrist and cannot perform medical foot treatments or offer medical advice until my studies are complete. By signing, you acknowledge that treatments performed is purely cosmetic.

I am currently balancing my business with my degree and my three young children, my appointment slots are strictly limited. My study schedule means I cannot always accommodate last-minute changes or late arrivals.


Thank you for respecting the balance between my student life and my studio!

I understand that Deanna is a Student Podiatrist and can not currently provide medical diagnosis, foot health treatments or advice. All current services are strictly Cosmetic only.

I understand that Deanna is a Student Podiatrist and can not currently provide medical diagnosis, foot health treatments or advice. All current services are strictly Cosmetic only.

I understand that my booking isn’t confirmed until I’ve paid the deposit

I understand that my booking isn’t confirmed until I’ve paid the deposit

Name & Date:

Signature
Contact details:
Email: