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What is next?

I work by appointment only, with practice days on weekdays and Saturdays. I look forward to meeting you and supporting you on your aesthetic journey.

After getting in touch with us, we will arrange a free consultation, either online or by phone. During this consultation, we will discuss your expectations and wishes and create a tailored plan for your treatment.

For in-person appointments, I allocate 1 to 1.5 hours to ensure we have sufficient time together. To secure your booking, a deposit of 10–25% of the treatment cost is required.

My practice is based in Cambridge, separate from my NHS work, in line with the General Medical Council’s Code of Medical Practice and to avoid conflicts of interest. I love Cambridge for its kind population, metropolitan feel, and excellent transport links. The therapy room is a safe, confidential space where all consultations and aesthetic interventions take place.

Our Practice Policy 

Aesthetics is a journey—and a relationship—between us. I will always provide honest, professional guidance and aim to build a long-lasting relationship with my clients. If needed, I may direct you to other services I cannot provide.

Before treatment, you will complete either a medical or aesthetic questionnaire. This ensures your safety and allows us to tailor your plan effectively.

We maintain detailed records of your treatments, including prescribed injections or facial procedures. Written consent is obtained before any intervention, including during consultations when planning treatments and taking facial photographs from different angles. This is both a legal requirement and beneficial for your records as we begin your journey together. All personal data is protected in accordance with the UK Data Protection Act 2018 (DPA 2018).

Aesthetics Questionnaire

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1. About You

  • Full Name:

  • Date of Birth:

  • Contact Number:

  • Email:

 

2. Your Visit Today

  1. What brings you to Miro Care Aesthetics today?
    (e.g., specific treatment, consultation, general advice)

  2. What are your main goals or concerns regarding your appearance?

  3. .Are there any areas of your face or body you would like to focus on?  

 

3. Your Perception

  1. How do you feel about your overall appearance?
    ☐ Very satisfied
    ☐ Mostly satisfied
    ☐ Neutral
    ☐ Somewhat dissatisfied
    ☐ Very dissatisfied

  2. How often do you notice or comment on your facial features in the mirror?
    ☐ Multiple times a day
    ☐ Once a day
    ☐ A few times a week
    ☐ Rarely

     3. Which features do you find most important or bothersome to you?

   

    4.Are there any past treatments or procedures you have had done?

         ☐ Yes ☐ No
         If yes, please specify: ____________________________________

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4. Your Expectations

        What outcome are you hoping to achieve from today’s consultation or treatment?

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        How important is a natural-looking result to you?
       ☐ Very important
       ☐ Somewhat important
       ☐ Neutral
       ☐ Less important

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       Is there anything specific you would like us to advise or educate you about during today’s visit

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5. Lifestyle and Self-Care

        How would you describe your current skincare or beauty routine?

        Are there any products or treatments you have had a strong reaction to in the past?
        ☐ Yes ☐ No
        If yes, please describe: ____________________________________

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       Signature: ________________________
       Date: ____________________________

Medical Questionnaire;

 

 

 

 

 

 

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Personal Details

         Full Name:

         Date of Birth:

         Address:

         Phone:

        Email:

 

1. General Health

  1. Do you have any chronic illnesses (e.g., diabetes, heart disease, autoimmune conditions)?
    ☐ Yes ☐ No
    If yes, please specify: ____________

  2. Do you have any allergies (including medications, food, latex, or skincare products)?
    ☐ Yes ☐ No
    If yes, please specify: ____________

  3. Are you currently taking any medications, including over-the-counter, supplements, or herbal remedies?
    ☐ Yes ☐ No
    If yes, please list: ____________

  4. Have you had any recent surgeries or hospitalizations?
    ☐ Yes ☐ No
    If yes, please provide details and dates: ____________

 

2. Skin Health

  1. Do you have any skin conditions (e.g., eczema, psoriasis, rosacea, acne)?
    ☐ Yes ☐ No
    If yes, please specify: ____________

  2. Have you had recent cosmetic procedures (e.g., chemical peels, laser treatment, fillers, Botox)?
    ☐ Yes ☐ No
    If yes, please provide details and dates: ____________

  3. Do you have a history of keloid scarring or delayed wound healing?
    ☐ Yes ☐ No

  4. Do you have any active infections, cold sores, or skin lesions in the treatment area?
    ☐ Yes ☐ No

 

3. Blood and Circulation

  1. Do you have any bleeding disorders or take blood-thinning medications (e.g., warfarin, aspirin)?
    ☐ Yes ☐ No

  2. Do you have any history of stroke, heart attack, or cardiovascular disease?
    ☐ Yes ☐ No

 

4. Neurological and Muscular Health

  1. Do you have any neurological disorders (e.g., epilepsy, Bell’s palsy, myasthenia gravis)?
    ☐ Yes ☐ No

  2. Do you experience frequent migraines or seizures?
    ☐ Yes ☐ No

 

5. Hormonal and Reproductive Health

  1. Are you pregnant, planning pregnancy, or breastfeeding?
    ☐ Yes ☐ No

  2. Do you have any hormonal disorders (e.g., thyroid disease, PCOS)?
    ☐ Yes ☐ No

 

6. Lifestyle Factors

  1. Do you smoke, vape, or use recreational drugs?
    ☐ Yes ☐ No

  2. Do you have a history of excessive sun exposure or tanning bed use?
    ☐ Yes ☐ No

 

7. Previous Adverse Reactions

  1. Have you ever had a reaction to anaesthesia, fillers, Botox, or other cosmetic treatments?
    ☐ Yes ☐ No
    If yes, please explain: ____________

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8. Consent & Declaration

I declare that the information provided is accurate and complete to the best of my knowledge. I understand that withholding information may increase the risk of complications.

 

         Signature: ___________________

         Date: ___________________

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Consent for Photography – Miro Care Aesthetics

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I hereby consent to photographs being taken of my face and/or treatment areas for the purpose of:

         Documenting my treatment progress

         Assisting in treatment planning

         Maintaining accurate medical/aesthetic records

I understand that:

        The photographs are confidential and will be stored securely in accordance with UK Data Protection laws (DPA 2018).

         My identity will not be shared without my written permission.

         I may withdraw this consent at any time.

 

         Patient Name: ________________________
   

         Signature: ___________________________
 

         Date: _______________________________

Payment and Refund policy;

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As a solo practitioner, I accept payment by cash, cheque, or bank transfer. Our refund policy is straightforward:

  • If I cancel the appointment for any reason, your deposit is fully refundable.

  • If you cancel at least 48 hours before your appointment, your deposit is fully refundable.

  • If you cancel or postpone within 48 hours of your appointment, the deposit is non-refundable.

Thank you for choosing Miro Care Aesthetics. I look forward to helping you feel confident and cared for.

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