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Client Consultation

Please fill out the following form to be prepared for your appointment. Thank you.

Have you ever had a facial treatment before?
Are you suffering from a medical condition, illness, or injury?
Have you ever had chemicals peels, laser treatments, or microdermabrasion?
In the last month?
Do you use Accutane, Retin-A, Renova, Adapalene Hydroxyl Acid or any other Retinol/vitamin A derivative products?
Have you experienced Botox, Restylane, or collagen injections?
Are you suffering from a medical condition, illness, or injury?
) What areas of concern do you have regarding your: Skin (Check all that apply)

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