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Medical Intake Form

Which Intake Form Do I Need?

To ensure your treatment is safe and tailored to your needs, we require all clients to complete an Intake Form before their appointment.
Different treatments may require different forms - simply find your booked service below and click the matching Intake Form button.

If you are unsure which form applies to your service, feel free to contact us and we’ll be happy to guide you.

This form applies to the following treatments:

  • Blood test - only morning

  • Carbon sauna

  • Collagen threads

  • Hydrafacial

  • Hydrogen Molecular Therapy Bundle

  • Hydrogen Molecular Therapy / Inhalation

  • Naturopath Bioresonance

  • Naturopath Consultation Online

  • Pressotherapy

  • Specialist Consultation Oncology


This form applies to the following treatments:

  • Naturopath Bioresonance

  • Naturopath Consultation Online

  • Oncological IV Therapy

  • Specialist Consultation Oncology

This form applies to the following treatments:

  • 24 k gold facial stamp

  • After party IV follow visit

  • Beauty IV – skin glow & anti-aging follow visit

  • Bb shaper - endermology body 1 treatment

  • Bb shaper - endermology body - bundle

  • Bb shaper - endermology body area - pack

  • Bio peeling abyss

  • Btl emsculpt

  • Carboxytherapy face/body

  • Carbon peeling

  • Coollllifting

  • Cryolipolysis

  • Detox IV – liver follow visit

  • Energy IV follow visit

  • Fat dissolving

  • Food poisoning IV

  • Green + red laser lipo + boa

  • Hair loss treatment

  • Hifu 3D face/body

  • Im B12 injection

  • Iprf fibrin

  • IV glutathione whitening

  • IV vitamin drip therapy first visit

  • Kiss eyes radiofrequency

  • Laser hair removal - 1 treatment

  • Laser hair removal - bundle

  • Laser radiofrequency microneedle

  • Laser tattoo removal

  • Laser veins removal

  • Mesotherapy needle

  • Microneedle dermapen

  • Mobile vitamin drip therapy dublin

  • Oncological IV therapy

  • Relax IV – stress relief follow visit

  • Scars removal

  • Vampire face lift

  • Vitamin C - 25 g , 50 g , 75 g

  • Vital IV – immunity follow visit

This form applies to the following treatments:

  • Oncological IV Therapy

Medical Intake Form FAQ

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