What we need to know

YESNO

YESNO

NURSEDOCTORDENTISTBEAUTICIANNVQOTHER

CIBTACCIDESCOITECVTCTFETACOTHER



Please tick all treatments that you offer:

Acoustic Wave Therapy Body ContouringAeroline Air Jet Body MassageAlkaline Skin WashAqua DetoxAromatherapyBio Skin Jetting/Bio Skin SmoothingBleaching of Superfluous HairBody Hair Colouring including BikiniBody Scrub/ Polish/ Wraps/ Exfoliation/Brushing/MasksBotulinum toxin (Licensed Practitioner Only)Chemical peelsCryotherapyDepilatory CreamsDerma planningDerma rollerDermal fillers (permanent)(Medical practitioner only)Diathermy EpilationDry Flotation TanksElectrolysisEyebrow ShapingEyebrow/Eyelash/Facial tintingEyelash Growth (Bimatopost, Latisse and Lumigan)Eyelash PermingEyelash/Eyebrow extensionsFace MasksFacials/Electrical Facials and High Frequency EquipmentFalse Lash ApplicationFemilift (Licensed practitioner only)Gels/Acrylics/ShellacHair transplant (FUE) (Medical practitioner only)Hair transplant (FUT/Strip method)Hairdressing treatments including hair extensions and application of third party hairdressing productsHD BrowsHydrafacialIntracelIV infusion therapy (Licensed practitioners only)Laser (Ablative) /IPL skin types 1-6Laser (Non ablative)Lipolysis/Vaser/Body titeLiposuction (Medical practitioner only)LVL Lashes/Lash liftMake up applicationManicuresManual Lymphatic Drainage (Using Massage Method)MassageMesotherapy all treatmentsMicro/Nano Current MachinesMicrodermabrasionMicroneedlingMicropigmentation, Microblading and/or Semi Permanent Make UpNail Extensions/Nail ArtNon – invasive laser body contouring proceduresNon-cancerous moles/skin tags/cysts/wart/Milia removalPedicuresPhlebotomyPlasma blast (Fibroblast)Platelet Rich Plasma (PRP) for facial/Neck rejuvenationPlatelet Rich Plasma (PRP) for O Shot and P Shot (Medical practitioner only)Platelet Rich Plasma (PRP) for scalp hair restoration, breast augmentation and genital rejuvenation. (Medical practitioner only)ProfacialRadio frequency treatmentsSclerotherapyShockwave/Acoustic Wave TherapySkin Analysis/ConsultationSpray on tansSunbeds/SunshowersTattooTattoo removalTeeth whitening (Licensed GDC practitioner only)Thread lifting – PDO/Silhouette soft (Licensed practitioners only)Thread lifting (Non dissolve) (Medical practitioner only)WaxingWeight loss lipolysis (Lipo-dissolve/Lipostabil/ Essentiale, Aqualyx) (Licensed practitioner only)

What we need to know

Are you aware of any claims or circumstances that could give rise to a claim in the last 5 years against you or your business? Please tick

YESNO

Has any application for this type of insurance cover ever been Declined, Cancelled or Required any special terms?

YESNO

Please tick the appropriate box if you are qualified and/or hold a license to practice any of the following:

NURSEDOCTORDENTISTBEAUTICIANNVQOTHER

Please confirm what beauty therapy qualifications you hold (if applicable):

CIBTACCIDESCOITECVTCTFETACOTHER



Please tick all treatments that you offer:

Acoustic Wave Therapy Body ContouringAeroline Air Jet Body MassageAlkaline Skin WashAqua DetoxAromatherapyBio Skin Jetting/Bio Skin SmoothingBleaching of Superfluous HairBody Hair Colouring including BikiniBody Scrub/ Polish/ Wraps/ Exfoliation/Brushing/MasksBotulinum toxin (Licensed Practitioner Only)Chemical peelsCryotherapyDepilatory CreamsDerma planningDerma rollerDermal fillers (permanent)(Medical practitioner only)Diathermy EpilationDry Flotation TanksElectrolysisEyebrow ShapingEyebrow/Eyelash/Facial tintingEyelash Growth (Bimatopost, Latisse and Lumigan)Eyelash PermingEyelash/Eyebrow extensionsFace MasksFacials/Electrical Facials and High Frequency EquipmentFalse Lash ApplicationFemilift (Licensed practitioner only)Gels/Acrylics/ShellacHair transplant (FUE) (Medical practitioner only)Hair transplant (FUT/Strip method)Hairdressing treatments including hair extensions and application of third party hairdressing productsHD BrowsHydrafacialIntracelIV infusion therapy (Licensed practitioners only)Laser (Ablative) /IPL skin types 1-6Laser (Non ablative)Lipolysis/Vaser/Body titeLiposuction (Medical practitioner only)LVL Lashes/Lash liftMake up applicationManicuresManual Lymphatic Drainage (Using Massage Method)MassageMesotherapy all treatmentsMicro/Nano Current MachinesMicrodermabrasionMicroneedlingMicropigmentation, Microblading and/or Semi Permanent Make UpNail Extensions/Nail ArtNon – invasive laser body contouring proceduresNon-cancerous moles/skin tags/cysts/wart/Milia removalPedicuresPhlebotomyPlasma blast (Fibroblast)Platelet Rich Plasma (PRP) for facial/Neck rejuvenationPlatelet Rich Plasma (PRP) for O Shot and P Shot (Medical practitioner only)Platelet Rich Plasma (PRP) for scalp hair restoration, breast augmentation and genital rejuvenation. (Medical practitioner only)ProfacialRadio frequency treatmentsSclerotherapyShockwave/Acoustic Wave TherapySkin Analysis/ConsultationSpray on tansSunbeds/SunshowersTattooTattoo removalTeeth whitening (Licensed GDC practitioner only)Thread lifting – PDO/Silhouette soft (Licensed practitioners only)Thread lifting (Non dissolve) (Medical practitioner only)WaxingWeight loss lipolysis (Lipo-dissolve/Lipostabil/ Essentiale, Aqualyx) (Licensed practitioner only)