Skin Consultation Form

 

Please fill out the skin care client consultation form to the best of your ability. Please allow up to 48-72 hours (business days) for a response.

What is your skin type?
What is your Fitzpatrick Scale? (Skin Complexion)
What are your skin care concerns?
What Skin Care Products are you currently using?
Have you used Accutane, Adapalene, Differen, Glycolic Acids, Lactic Acids, Mandelic Acid, or Retinol?
Have you received a chemical peel or any laser treatments recently?
Have you used acne medication?
Have you received any Botox or dermal fillers in the past 14 days?
Do you currently have or have experienced any health conditions listed below?
Do you have any of the following?
Do you follow a healthy diet?
Do you smoke?
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Do you have any allergies?
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Facials

Facials

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