Finest Facials & Skinvigoration
Have you ever had a facial treatment before? No Yes, when?
Do you have any special skin problems or concerns? No Yes, specify:
Do you use Retin-A, Retinol/vitamin A derivative products? No Yes, specify:
Have you used an acne medication? No Yes, when?
Have you used any hair removal methods in the past six weeks on you face? No Yes, specify:
Do you use tanning beds or tan outside? No
Have you had any Neurotoxin (Botox, ) or Filler (Juvederm, Radiesse, ) injections? No
Are you taking oral contraceptives? No Yes, specify:
Are you pregnant or trying to become pregnant? No Yes
Any menopause problems? No Yes, specify:
Are you undergoing any hormone replacement therapy? No Yes, specify: