Skincare History Questionnaire and Waiver Form

New Patient Form For Facial Treatments

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  • Skincare History Questionnaire and Waiver

    Health History

    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.

  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY