Oasis Health Questionnaire

Pre Appointment Health Questionnaire

* Indicates required field

Name *

First

Last

Mobile Number *

Email *

Adress Details *

Line 1

Line 2

City

State

Zip Code

Country

COVID RELATED QUESTIONS

In the last 14 days have you: Mixed with anyone diagnosed with COVID? Been Abroad? Had a Positive covid test? *

If you selected YES to any of the above Questions please give the details Here *

Have you had any of the following new symptoms in the last 7 days: *

Have you had a covid vacine? Please type No or Yes and the date of the vacine below *

HEALTH RELATED QUESTIONS

If one or more of the conditions listed below is applicable, please select the main one and give further details below. Thank you *

If you have select anything from the list above or have knowingly been allergic to any treatment or ingredients please type the details here. If nothing applies type N/A *

Please type below if you're taking any medication or there are any other health conditions we should be made aware of. *

Remember a patch test is required for Lash & Brow Tint, Lash Perm, IPL-Laser, Microblading. Please book 48hrs in advance. *

I hereby warrant that the above information is correct. On the assumption that attention is given by the staff of Oasis Health & Beauty, whilst receiving or taking part in any activity related to the treatments, use of equipments or advice recommended. I confirm that neither Oasis Health & Beauty or its staff are responsible to me if any injury to health or well-being is incurred. I'm happy to recieve emails/messages from Oasis. All information is stored according to European GDPR regulations and not share out of the group. *

CLICK HERE TO SEND

Pre Appointment Health Questionnaire

Back to the Booking form or Pre appointment advise