Consultation Form | Glaze Nail Studio

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Glaze Nail Studio Consultation Form

First name

Last name

Phone

Birthday

Day

Month

Year

Are you currently receiving any medical treatment or taking any medications that may affect your nails?

Yes

Do you have any allergies or have you had any adverse reactions to nail products in the past?

Yes

Have you ever had trouble with extensions in the past? (e.g lifting, breakage, sensitivity, popping off)

Yes

When is the last time you had a professional nail service?

What is your occupation?

Do you require product removal? (Foreign product removal available once for new clients only $30)

Yes (Foreign Removal)

Yes (Glaze Work)

Gel/Dual Form Extension Preferences (if applicable)

Desired Length

Short

Medium

Long

Extra Long

Desired Shape

Square

Almond

Coffin/Ballerina

Stiletto

What Nail Art Tier do you want? (if applicable)

Tier One (Dots, Lines, Abstract, Accent Nails)

Tier Two (French, Blooming Gel, Marble, Cat Eye)

Tier Three (3D Art, Hand Drawn, Charms, Chrome)

Tier Four (Highly Detailed, Custom Nail Art)

No Art, Plain Colour

Are you preparing your nails for a special occasion?

Yes

Are there any specific concerns or requests you have regarding your gel extensions, builder gel, hard gel or your natural nails?

Please upload any nail art inspiration picture you may have!

How did you hear about Glaze?

Google

Facebook

Instagram

Friend

Nail Service Consent & Aftercare

Appointments & Maintenance

Schedule: 3-4 week appointments are required to prevent lifting, breakage, or infection.
Fees: Each appointment incurs a separate service cost.

Aftercare Essentials

Daily: Apply cuticle oil and clean gently with a soft brush.
Protection: Wear gloves for cleaning/chemicals. Avoid acetone and rough tools.
No Tampering: Do not pick, bite, or self-remove.
Alert: Contact your tech immediately for pain, redness, or swelling.

Risks & Results

Process: Services use artificial tips and builder gels cured under UV/LED light.
Risks: Minor risks include sensitivity, reactions, or lifting.
Variables: Results depend on natural nail health and proper home care.

Health & Consent

Disclosure: I have provided accurate health/allergy info and will update it as needed.
Media: Photos/videos require my verbal consent.
Patch Test: Recommended for those with known sensitivities.

Liability The technician is not responsible for damage caused by poor aftercare, undisclosed allergies, or accidental trauma.

Signature

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