Nail Client Intake and Contraindication Record

Nail Technician | PublicProof Academy working document

Non-editable educational sample of record categories. Not an approved clinical form or treatment protocol. A qualified professional must review suitability before use in their own secure system.

Business

State or jurisdiction

Prepared on

Owner

Official source saved

Next review

Client details

Name
Phone and email
Date of first visit
How they found you
Preferred service and length

Health screening (client completes)

Diabetes or circulatory condition
Currently pregnant
Known allergy to acrylates, gel, latex or adhesives
Previous reaction to a nail service
Blood thinners or immune-suppressing medication
Recent surgery or injury to hands or feet
Athlete's foot, warts, or suspected nail fungus
Ingrown nail that is red, swollen or painful
Open cuts, sores or rash on hands or feet
Under the care of a podiatrist or dermatologist

Technician assessment

Nail plate and free edge condition
Cuticle and surrounding skin condition
Signs of infection present (if yes, do not service - refer)
Calluses or corns present (softening and abrasion only; no penetration of skin)
Service proceeding as requested / modified / declined
Reason for modification or refusal
Referral given to which practitioner

Consent, products and aftercare

Service performed and products used (record brand and system)
Client told about product sensitivity risk and avoiding skin contact
Patch test offered or performed where appropriate
Aftercare instructions given (written copy provided)
Rebooked for (date)
Photographs taken with permission (Y/N)
Technician name, licence number and signature
Client signature and date

Use rule: Education and organization only. Record the agency, official source, checked date, cost, proof saved and responsible person for every consequential requirement. Unknown means stop and confirm. Example rows are labeled EXAMPLE and are not your data.