• Facial Consultation Form

    Answer the best you can! It's just to give me an idea to help you achieve your skincare goals; please take your time.
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  • YOUR SKIN CARE

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  • HEALTH HISTORY

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  • LIFESTYLE

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  • I understand, have read and completed this questionnaire truthfully. I agree that this constitutes full disclosure,and that it supersedes any previous verbal or written disclosures. I understand that withholding information or providing misinformation may result in contraindications and/or irritation to the skin from treatments received. The treatments I receive here are voluntary and I release this institution and/or the technician/esthetician/skin care professional from liability and assume full responsibility thereof.

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