Body Contouring Treatment Record

Client Name: *

Client Date of Birth: *

Client Email: *

Has there been any change in your medical conditions since your initial appointment: *

Please give details:

Client Signature: *

Tap or click on the signature above to sign

Practitioner Signature: *

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Arms

Date:

Measurement Before:

Measurement After:

Time Start:

Time End:

Bra Line/Chest

Date:

Measurement Before:

Measurement After:

Time Start:

Time End:

Upper Abdomen

Date:

Measurement Before:

Measurement After:

Time Start:

Time End:

Lower Abdomen

Date:

Measurement Before:

Measurement After:

Time Start:

Time End:

Flanks

Date:

Measurement Before:

Measurement After:

Time Start:

Time End:

Thighs Inner

Date:

Measurement Before:

Measurement After:

Time Start:

Time End:

Thighs Outer

Date:

Measurement Before:

Measurement After:

Time Start:

Time End:

Chin

Date:

Measurement Before:

Measurement After:

Time Start:

Time End:

Client's Body Fat Percentage:

Comments:

Photos:

Data Protection and Privacy

We are committed to protecting your privacy. We take special precautions with your sensitive personal data and we will process your data lawfully and as described. We only process the data we need for as long as we need to and we respect all of your rights under GDPR. We will never sell, share or otherwise abuse your data. You can contact us at anytime to request your data, change your preferences or request that your data be deleted. GDPR is the European privacy law designed to protect you and give you control of your data.