Beez New Client Application

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Is the Client over 16?* This field is required.
YESNO
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WE DO NOT ACCEPT CLIENTS UNDER 16.

PLEASE STOP HERE
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First Name (Nombre Primero)* This field is required.If you are filling for a client that is under 18 please fill out the form with THE CLIENTS information NOT THE GUARDIAN.
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Last Name* This field is required.If you are filling for a client that is under 18 please fill out the form with THE CLIENTS information NOT THE GUARDIAN.
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Email (Correo Electrónico)* This field is required.
example@example.com
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Cell Phone (Teléfono Celular)* This field is required.
cell phone number
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Necesitas servicios en español? (do you need services in Spanish)* This field is required.
SiNo
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How did you hear about us or who referred you?* This field is required.
Google
Instagram
Yelp
Facebook
TikTok
Walked By
Other
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Which best describes your skin?* This field is required.select the best answer
I have acne currently
I maybe occasionally have "congestion"/small bumps/blackheads.
I used to have acne, but now I'm clear.
I've never been to an acne clinic but I use face reality or vivant skin care, and I got your info from their website.
I never had acne, I've always been clear.
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At this time, The Beez Kneez Skin Care & Acne Clinic is NOT accepting NON-ACNE CLIENTS. If you are a direct referral PLEASE CONTINUE, or feel this may be a mistake, please email us directly at EMAIL US.

PLEASE STOP HERE
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Which best describes you?* This field is required.CHECK ALL THAT APPLY
I'm committed to clearing my skin. I've never been to an acne clinic.
I went to the dermatologist and things are not getting better. I'm ready for change.
I'm just shopping around for a facial place.
I'm coming from another acne clinic but still breaking out and haven't been clear YET.
I'm on maintenance, I'm coming from another acne clinic.
ummm... I thought I would get clear after only ONE TREATMENT???
I have a big event I want to be clear for less than 3 months away
I fell off in my treatments but ready to return.
I'm busy, and frequently have to reschedule last minute.
I only am looking for just one facial for a special occasion.
I'm not ready to commit to in person treatments, I need virtual.
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What results are you wanting to achieve? Is there anything else you'd like to share?Please type your questions or concerns below.* This field is required.
please share your thoughts
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VERY IMPORTANT — PLEASE READ

Your consult is approx. 1.5 hours. Please plan accordingly.

Your consultation includes:
• Deep-dive discussion & education
• Skin analysis
• Nutrition & lifestyle assessment
• Personalized home-care routine

We can help you if you:

New to acne facials and/or treatments

You are NOT CLEAR YET or feel stuck

Have "Tried everything" w/no results

You don't know what to do

Transferring from another clinic (still need a consult prior to treatment)

You're CLEAR now, wanting to focus on minimizing future breakouts

Need acne clinic in your area for maintenance & continued care

Pregnant/or breastfeeding with acne

Please note:
• You must use our recommended home care products to receive acne treatments.
• Home care is essential, treatments alone won’t clear your skin.
• Our products are fully researched and tested.
• A typical full routine that last 2-4 months ranges $180–$300 (varies by product).
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You have the choice of an in-person consultation or virtual. Please choose which format you'd prefer.
In-Person
Virtual
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BASED ON YOUR ANSWERS So Far We Are Perfect For You!
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Booking Instructions:

A VALID Credit card required to hold your appointment.

Once you submit you'll be taken to the booking page → Choose In-Person or Virtual

Pick a date and time from our calendar

Follow the prompts to book

No times work? Join our waitlist.

Add info@thebeezkneezsf.com to your contacts so our emails don't land in spam.

Important: You will receive a few follow-up emails with details to prepare for your 1st appointment.

All essential documents and reminders are sent via email.

If you unsubscribe and miss your appointment, you are responsible. We do not send spam.

For questions or issues, please email us. We’ll respond quickly.

Click "SUBMIT" to confrim you have read the above and understand the booking instructions.
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Please verify that you are human* This field is required.
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