Image Skincare
Centre of Excellence

An Image Skincare Centre of Excellence

Good Salon Guide
★★★★★

Good Salon Guide ★★★★★

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Appointment Check-In

ONLY FILL IN THIS FORM IF YOU HAVE A CONFIRMED APPPOINMENT

IF YOU NEED TO BOOK AN APPOINTMENT: CLICK / TAP HERE

Name *

Your CONFIRMED Appointment Date & Time:*

Appointment Date *

Date

Appointment Time *

Time

Type of treatment you are attending for: *

Treatment:

The treatment you will receive is a clinical treatment using active cosmeceutical products and no guarantee is expressed or implied as to the precise results.

Consent *

I consent to receive the above listed treatment at the above listed day/time.
I agree to make my skincare therapist aware of any changes to my health, medications, or lifestyle prior to treatment that could effect my results or conflict with my treatment.

Consent (copy) *

I consent to receive the above listed treatment at the above listed day/time.

7 William Street • Kilkenny • R95VHN7

Open by appt only

info@eyrebrushed.ie

7 William Street
Kilkenny
R95VHN7

Open by appt only

info@eyrebrushed.ie

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Appointment Check-In

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Home
Take a Skin Test
Skin Consultations
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Skin Clinic Treatments
About
Shopping Cart
Appointment Check-In