Nail Technology Treatment

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					Client Consultation Form – Nail Technology
College Name: College Number: Student Name: Student Number: Date: Client Name: Address: Profession: Tel. No: Day Eve

PERSONAL DETAILS Age group: Under 20 20–30 Lifestyle: Active Sedentary Last visit to the doctor: GP Address: No. of children (if applicable): Date of last period (if applicable):

30–40

40–50

50–60

60+

CONTRAINDICATIONS(select if/where appropriate): Transverse ridges Lamella dystrophy Vertical ridges Onychomycosis (Tinea Ungium) Beau’s line Onychoptosis Blue nail Onychatrophia Psoriasis Onychauxis Eczema Onychorrhexis Paronychia (Whitlow) Onychogryphosis Sepsis Onychogryposis Leuconychia Onycholisis Flaking Onychocryptosis Dry/Brittle nails Koilonychia Pitting Onychophagy Pterygium Onychophyma Onychia Mould Hang nail NAIL TEST Moisture content: Excellent Cuticle condition: Excellent Skin condition: Dehydrated Skins healing ability: Excellent Circulation: Good Overall Nail/Cuticle condition: REASON/S FOR TREATMENT: AREA TO BE TREATED: Toe nails Finger nails NAIL SYSTEM TO BE USED (select where appropriate): Gel Acrylic Silk wraps Infills Repair

Warts Verucca Loss of skin sensation Diabetes Allergies Corns Chilblains Cuts Abrasions Broken bones Discolouration Severely bitten nails Severely bitten/picked skin around the nail

Good Good Dry Good Normal

Fair Fair Normal Fair Poor

Poor Poor Poor

Client Lifestyle:

Treatment plan including infills:

PHOTOGRAPHS - BEFORE AND AFTER

Rationale for choice of the system:

Home care advice:

Reflective practice:

Overall conclusion of case study:

Therapist signature…………………………….. Client signature …………………………………