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Medical questionnaire

This helps us identify any reasons we might not be able to treat you, and lets us prepare for your visit. Please answer honestly.

Are you currently pregnant or breastfeeding? Do you have any known allergies (medication, latex, anaesthetic, hyaluronic acid)? Are you currently taking any medication or supplements? Have you had any aesthetic treatment in the last 4 weeks? Do you suffer from cold sores? Have you had dental work in the last 2 weeks (or planning to soon)? Do you have any active skin conditions, infections, or recent skin treatments? Please give details for any "yes" answers above

Consent I consent to my personal and medical information being held by Medispa Bath for the purposes of providing care. My data will not be shared with third parties. * I consent to before/after photos being used on the Medispa Bath website and social media. (Optional — you can decide on the day.)

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