Client Consultation Form – Make-up
College Name: Eveline Charles Academy
College Number: N/A
Learner Name: Cortney Babee Learner
Number: 2018E5DSEP04
Date: February 19, 2019
PERSONAL DETAILS
Age group: Under 20
20–30
30–40
Lifestyle: Active
Sedentary
Last visit to the doctor: N/A
GP Address: N/A
No. of children (if applicable): One
Date of last period (if applicable): N/A
Client Name: Danielle Balchen
Address: N/A
Profession: Book Keeper
Tel. No: Day: N/A
Eve: N/A
40–50
50–60
60+
CONTRAINDICATIONS REQUIRING MEDICAL PERMISSION – in circumstances where medical
permission cannot be obtained clients must give their informed consent in writing prior to treatment
(select if/where appropriate):
Medical oedema
Skin cancer
Nervous/Psychotic conditions
Slipped disc
Epilepsy
Undiagnosed pain
Recent facial operations affecting the area
When taking prescribed medication
Diabetes
Whiplash
CONTRAINDICTIONS THAT RESTRICT TREATMENT (select if/where appropriate)
Fever
Hormonal implants
Contagious or infectious diseases
Recent fractures (minimum 3 months)
Under the influence of recreational drugs or
Sinusitis
alcohol
Neuralgia
Diarrhoea and vomiting
Sunburn
Any known allergies
Migraine/Headache
Eczema
Hypersensitive skin
Undiagnosed lumps and bumps
Botox/dermal fillers (1 week following treatment)
Hyper-keratosis
Localised swelling
Inflammation
Skin allergies
Cuts
Styes
Bruises
Watery eyes
Abrasions
Trapped/pinched nerve affecting the treatment
Scar tissues (2 years for major operation and 6
area
months for a small scar)
Inflamed nerve
Sunburn
Eye infection
Conjunctivitis
SKIN TEST (select if/where appropriate):
Moisture content:
Excellent
Good
Fair
Poor
Muscle tone:
Excellent
Good
Fair
Poor
Elasticity:
Excellent
Good
Fair
Poor
Sensitivity:
High
Medium
Low
Skins healing ability: Excellent
Good
Fair
Poor
Skin tone:
Fair
Medium
Dark
Olive
Circulation:
Good
Normal
Poor
Pores:
Fine
Dilated
Comedones
Milia
Overall Skin Type: Normal
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TREATMENT TO INCLUDE (select if/where appropriate):
Day make-up
Evening make-up
Special occasion make-up
Bridal Make-up
Other:
Treatment details:
To include product/colours used, make-up chart and before and after photographs)
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Cleansed, toned and moisturized using Clean and Clear gel moisturizer
Skin analysis – combo skin, face shape oblong
Applied the make-up using sponges and sanitized brushes where applicable.
Tested the colour of the foundation at the side of the face along the jaw line.
Make-up Chart
Pre-base:
Concealer
Corrective cream
Foundation
Powder
Blusher
Shader
Highlighter
Eye shadow
Eye liner
Mascara
Lip liner
Lipstick
Lip gloss
MF Primer – applied all over the face and neck
Light concealer on sides of nose, under eye area
Not used this treatment
MF Water Blend Y225
Translucent loose powder
MF Peachy Pink
Under the check bones, forehead, jawline
Not used this treatment
Cream, Beige
Soft black powder
MF Aqua Seal mascara
Dusty Rose
Dusty Rose
Not used in this treatment
Client feedback:
Client was impressed with her more defined brows and enjoyed the subtle eye makeup and pop of
soft lip color.
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Aftercare/homecare advice given:
 Continue morning and evening cleansing and moisturizing routine
 Use an exfoliation product once per week
 Use a mask for a combination skin approximately once a week or when needed
 Practice makeup techniques taught for successful daytime application, email any
questions or rebook at anytime for consultation
Therapist/Learner’s signature…………………………………..
Client’s signature………………………………………...............
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