B4 – Provide Facial & Skin Care Treatment
NVQB28 – Provide Stone Therapy
|Therapist Name |Date |
|VTCT Number |Portfolio number |
|Client Name |Assessment |Yes |No |
|HSLO11 p |Standard |Summative |Formative |
|Male / Female New/ Existing | | | |
|(past records checked) | | | |
|H&SLO4 a,i,j,o,p |HSLO6 c,l |HSLO6 c,l |
|H&S LO5 c,e,l,m |General contra indication |Local contra indications |
|H&SLO6 n |May prevent full service |Service requiring adaption |
|Health & Safety check |( Bacterial infection |( Recent scar tissue |
|( Sterilised tools |( Viral infection |( Recent operation |
|( Hands sanitised |( Fungal infection |( Psoriasis |
|( Area free from obstruction |( Parasitic infection |( Eczema |
|( Adequate temperature |( Heart condition |(Varicose veins |
|( Adequate lighting |( Diabetes |(Sun burn |
|( Adequate ventilation |( Cancer |Temporary contra indications |
|( Materials disposed of in accordance to H & S |( High/low BP |Service may require adaption |
|regulations |( Undiagnosed lumps |( Medication |
|( Electrics checked |( Loss of skin sensation |( Bruising |
|( products dispensed correctly |( Deep Vein Thrombosis (DVT) |( Skin abrasions |
|( Stones disinfected |( Epilepsy |( Oedema |
|(Thermal tests |( Chemotherapy/Radio |( During Chemo/Radio therapy |
|(Follow Professional Ethics | |( Product allergies |
| | |( Pregnancy |
|HSLO6 d,n HSLO11 a |
|Lifestyle Question and Analysis (Questioning) |
| |
|Any medical history which may restrict or prohibit the service application? |
|Indicate any modification of treatment, or reasons why treatment could not be carried out: |
| |
|Currently taking any medication which may affect the appearance of the skin or skin sensitivity? |
| |
|Current dietary plan |
|HSLO4 h,l |
|HSLO6 e |
| |
|Pre treatment indemnity signature; information is correct at time of treatment: |
| |
|------------------------------------------- |
| |
| |
| |
| |
|Current fluid intake |
| |
| |
|Current Stress levels 1-4 |
| |
|Current exercise habits |
| |
|Smoker? |
| |
|Description of sleep patterns |
| |
|Treatment objectives |
|( Relaxation ( Balancing ( Uplifting ( Sense of well-being ( Local congestion (relief from tension |
|Treatment Areas |HSLO6 g,i,j |
| |Physical Characteristics(Visual) |
|( Face |( Mesomorph |
|( Neck, Chest & Shoulders |( Endomorph |
|( Abdomen |( Ectomorph |
|( Head |( Posture checked |
|( Arms & hands |( Posture abnormalities present? ________ |
|( Legs & Feet |( Skin Type assessed |
|( Back | |
|HSLO4 n, HSLO11 w | |
|Service Times: ( 75 mins ( 60 mins (30 mins | |
|HSLO7 c HSLO10 i |HSLO10 a |
|Products Used (Manual) |Equipment Used |
|( Basalt ( Marine |( Stone heater ( Cooling systems |
|( Marble ( Semi precious stones |( Accessories ( Stones |
|( Oil | |
|HSLO6 b,f,n,o HSLO 11 v HSLO 12 a,b,c,d |HSL11 c,d,e,f,m |
|After Care Advice |Techniques |
|( Recommended time intervals between services. |( Rotation of stones |
|( Modification of lifestyle patterns |( Alternation of hot and cold stones |
|(Encourage client to seek medical advice |(Hot stones only |
|(Time for questions |( Cold stones only |
| |( Combination of stone types and sizes |
| |(Chakras |
|Massage Techniques |Retail Opportunities |
|( Effleurage ( Petrissage ( Tapotement |( Products suitable to use at home |
|( Tapping ( Frictions (Tucking (Placement |( Progression of service plan |
|(Trigger points |( New product or service offered to the client |
|HSLO11 l |
|Client Evaluation e.g. polite, professional, capable. Explanation of treatment good/not enough. Please feel free to put any comments |
|down about the salon, therapist and treatments to enable us to provide a good service. Thank you. |
| |
| |
| |
|Client Signature Date |
|Therapist self evaluation |
|The technique I can do well is: |
| |
|I feel I need to improve on: |
| |
|I encourage my client to rebook for: |
|This is because: |
|Did they rebook with you? Yes/ No |
| |
|Therapist Signature Date |
|Assessor Feedback |
| |
| |
| |
|Oral questions asked relating to: |
|( H & S ( C.I’s ( Routine (Products ( Home care ( C.A’s ( Consultation |
| |
|Assessor Signature Date |
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