Consultation Form – Please review the following questions and conditions to determine whether any apply to you.
If any of the listed conditions apply to you, or if you have any medical conditions, allergies, or are currently taking any medications, please contact us before booking to ensure the treatment is safe and suitable for you.
Do you have any short / long term medical conditions?
Are you currently taking any medications?
Do you have a history of cancer and undergone radiotherapy or chemotherapy in the past 5 years?
Do you have a pacemaker or have you suffered from any heart conditions in the past?
Do you have any High/Low blood pressure issues?
Are you suffering from any form of liver / kidney disease or infection?
Are you recovering from any operation within the last 12 months?
Are you suffering from or had thyroid, fibrosis or hepatitis in any form?
Do you have current or any history of internal bleeding?
Are you taking or have you taken steroids/cortisone in the past 12 months?
Diabetes, Pregnant or Breastfeeding, Menopause, Epilepsy, Osteoarthritis, Skin Conditions or diseases, Asthma/hayfever/other allergiesBlackouts/faintness/dizzinessProne to bruising easily, Metal plates in body, Copper IUD Deep thrombosis/varicose veins, High levels of triglycerides, None of the above
Any filler, botox or implants? Please specify where
Services
Treatments
34 Main Street, Kirby Muxloe, Leicester, LE9 2AL, GB
Monday: 9:00 - 21:00 · Tuesday: 11:00 - 21:00 · Wednesday: 16:00 - 21:00 · Thursday: 9:00 - 21:00 · Friday: 9:00 - 14:00