We move to Milford from 1 October 2026 at 2A Dodson Avenue, Milford, in the Village Medical / Dr Frances Pitsilis building, upstairs from Kate Sheppard Midwifery.
Smooth by Adina Skin logo Smooth by Adina SkinSugaring · Waxing · Electrolysis
Body Skin · Treatment Suitability

Body Skin Consultation.

Complete this form before your first Body Skin treatment, or whenever relevant health, medication or skin information has changed. It helps Adina decide which treatment and modalities are appropriate for you.

VIEW BODY SKIN MENUSTART CONSULTATION

Body Skin Consultation Form

Fields marked as required must be completed before the form can be sent.

1 · Your details

2 · Treatment interest

3 · Recent hair removal & skin procedures

4 · Treatment safety screen

Select Yes or Unsure if any item may apply. This does not automatically mean you cannot have treatment; it may simply change the treatment plan.

Active skin issue: infection, open wound, cold sore/herpes outbreak, sunburn, inflamed rash, boil, infected ingrown hair or actively inflamed breakout in the area.

Electrical/device considerations: pacemaker or implanted electrical device, epilepsy/seizure history, or metal implant in/near the treatment area.

Medication/healing considerations: current or recent isotretinoin/prescription retinoids, blood-thinning medication, photosensitising medication, poor wound healing or raised/keloid scarring.

Pregnancy or breastfeeding: relevant because some modalities may need to be avoided or modified.

Respiratory or heat sensitivity: asthma, respiratory sensitivity to steam/ozone, rosacea-prone or highly heat-reactive skin in the area.

5 · Consent & acknowledgement

Your form is sent directly to book@adinaskin.nz. Do not enter payment-card details. Read our Privacy Policy.

Submitting this form does not confirm an appointment or guarantee that every modality will be suitable.