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Client Intake Form

Complete your digital intake form prior to your appointment. This form is required for both New & Repeat Clients.  

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Client Intake Form

Please take a few moments to answer the following questions. Your responses will assist us in understanding your skincare needs and enable us to provide you with a customized service that caters to your skin's specific requirements. Submissions are MANDATORY 24 h
ours prior to your appointment.
Are you a new or returing customer?
Are you 18 years or older?
Have you had any adverse reactions to skincare producs or facial treatments?
Are you taking any medications? Do you use any prescription skincare? ie. Accutane or Tretinoin
Do you have any allergies?
Are you currently experiencing any skin allergies, senstivities, or conditions?
Are you a smoker? (Tobacco, Hookah, Marijuana...etc)
Are you Pregnant or Breastfeeding?
Have you had any Facial/Dermatology/Cosmetic services or used any Retinoids in the past 30 days?
What type of skin do you have?
Are you currently using any products with actives or exfoliating ingredients?
Are you open to purchasing professional skincare recommended by your esthetician?
How often do you perform a skin care routine?
What concerns do you have regarding your skin? Please select all that apply
To achieve optimal results, a series of treatments along with a consistent and well-balanced skincare routine is recommended. How frequently do you anticipate scheduling facial treatments for yourself?
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