Registration & Health Declaration — Bed Light & Beyond, N7 0BT

Registration & Health Declaration

Please complete this before your first Red Light Therapy, Premium Tanning or Meditation session — it helps our team keep every session safe and suited to you.

Draft for review — form does not submit yet; live submission and CRM routing connect at launch.

Your details Full name Date of birth Email Phone Emergency contact name & number

Health declaration I confirm I am 18 years of age or over. I am pregnant, or think I may be pregnant. I am taking any photosensitising medication (e.g. certain antibiotics, acne treatments, St John’s Wort). I have epilepsy or a history of seizures. I have, or have had, skin cancer or a serious skin condition. There is anything else about my health our team should know before my session.

Consent I have read and agree to the Terms & Conditions and Privacy Policy. I confirm the information I’ve given above is accurate to the best of my knowledge.

Prefer to do this in person? You can complete this at reception on arrival instead.