Skincare History Questionnaire and Waiver
Please answer the following questions so that your Skincare Specialist may have a better understanding of your general health and lifestyle, thereby enabling your Skincare Specialist to accurately analyze and assess your skincare needs.
Please select the following conditions you have or had experienced:
Have you ever had an allergic reaction to any of the following:
Female clients only:
Please check if you are presently using or have used in the past any of the following:
Do you have or have you had any of the following in the last 14 days?
What Skincare products are you currently using at home?
PLEASE CHECK IF YOU ARE PRESENTLY EXPERIENCING OR HAVE EXPERIENCED ANY OF THE FOLLOWING:
WHAT SKIN CONDITIONS DO YOU WANT TO IMPROVE?