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Client Record, Consent and Electrology Aftercare Mobile App

The Client Record, Consent and Electrology Aftercare mobile app provides a simple way for electrologists to provide helpful information and get consent from clients prior to hair removal procedures. The consent form app covers all the most important details of a hair removal visit, including client details, unwanted hair removal treatment details and risks associated with the treatment plan.

Once completed, the customizable app can be signed off on by the electrologist and the client, and the results are saved automatically to the GoCanvas cloud for your records. Be sure to also check out this client record keeping app template that can be customized for your needs as well.

  • Lendlease
  • The Cooperative
  • PG&E
  • Red Bull
  • Mirvac

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Take a peek inside the Client Record, Consent and Electrology Aftercare Mobile App

Included Features

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Included Fields

Customize to add, remove, or edit any of the fields below.

  • Ico date

    Date of Service:

  • Ico statictext

    This Section To Be: Completed by Licensed Electrologist and initialed by Client:

  • Ico textbox

    Electrologist’s Name:

  • Ico textbox

    Electrologist’s License Number:

  • Ico date

    Exp.

  • Ico textbox

    Treatment Area:

  • Ico multiline

    Type of Service Performed:

  • Ico date

    Date Service Performed:

  • Ico signature

    Client Please Initial

  • Ico date

    Date:

  • Ico statictext

    This Section To Be: Completed by Client

  • Ico textbox

    Client’s Name:

  • Ico multiline

    Address:

  • Ico textbox

    Phone:

  • Ico date

    Date of Birth:

  • Ico dropdown

    Please check (√) if you have any of the following?

  • Ico multiline

    Other: Include any other medical issues, skin conditions, or diseases that may affect your electr...

  • Ico multiline

    List any sensitivities to medications or topical solutions:

  • Ico statictext

    INFORMED CONSENT is both a process and a document – neither can stand alone as informed consent.

  • Ico statictext

    The information I supplied on this form is true and correct to the best of my knowledge.

  • Ico statictext

    Having been informed of the potential risks, possible reactions, side effects and potential compl...

  • Ico signature

    Signature (Licensed Electrologist)

  • Ico date

    Date

  • Ico signature

    Signature (Client)

  • Ico date

    Date

  • Ico dropdown

    Possible Reactions, Side Effects and Potential Complications of the Service Provided:

  • Ico dropdown

    Aftercare Documents Provided:

  • Ico dropdown

    Informed Consent Provided:

  • ...and More!

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