Enhanced Skincare Waitlist Form

Hi! Thank you for being here!

Please read this section completely before filling out your form!

My process might be a little different than what you think of a traditional esthetician. My focus is corrective/revisional skincare. I rely heavily on home care in conjunction with results driven treatments to reach my client’s goals.

At this time, I am only interested in working with individuals who are ready to achieve their healthiest possible skin. I consider my client relationships as more of a partnership. If you are just wanting to come in one time or for a special occasion, we are probably not going to be a good fit, and that is okay!

Great skin starts at home. A consultation is going to be the first step in the process. We will have a thorough conversation about your skin concerns/goals and a skin analysis which will allow me to put together a custom routine for you that will specifically target your concerns + work for YOUR skin. I will provide you with step by step usage instructions and guide you through the acclimation process with the new products. If you are interested in coming in for treatments, I will keep you on my list and work you into the treatment room as my availability allows. To be completely transparent, I am not able to give any sort of timeline on when I will be able to get you in for treatments. I don’t believe I will ever stop taking new clients as I want to help as many individuals as possible with their skin care needs, however, I do want to be realistic in saying that I am taking very few new clients in the treatment room and prioritizing those who truly value their skin health. I have a very full book of regular, dedicated clients, and I will always give them precedence for booking. If you become an in-clinic client, please know that this would apply to you also which is why I have to make sure I have enough space when bringing in new clients for treatments. If I had it my way, I would treat each and every person’s skin who reaches out, but I am only one person, and I need to ensure that I am giving my time and energy to those who are going to reciprocate.

I have and continue to pour countless hours, so much energy, and finances into educating myself and providing the best possible medical grade products alongside the top technology for in-clinic treatment offerings. I need to focus my attention where my passion lies-and that is in helping others achieve their best skin!

If you are ready to make the commitment to a full home care regimen + guidance, I would absolutely LOVE for you to fill out this form & come in for a consultation.

Thank you for taking the time to read this, and I hope to meet you soon 😊

-Elizabeth

Full Name*

First NameLast Name

Phone Number*

Format: (000) 000-0000.

E-mail*

example@example.com

Date of Birth*

What are your skin concerns? Please check all that apply.*

If I could wave a magic wand and correct your top 3 skin concerns, what would they be?*

Please upload front facing and side profile view photos of your current, bare skin in natural lighting.*

Does your skin feel tight/dry after getting out of the shower?*

YesNoSometimes

Does your skin ever feel oily?*

YesNo

Please include a photo of your current AM routine with products placed in the order of usage.*

Please include a photo of your current PM routine with products placed in the order of usage.*

Please include a photo of any "extra" skincare items that you use on occasion.*

Please list how long you have been using your current products.*

Is your current routine delivering the results you desire?*

YesNo

How often are you exfoliating your skin?*

Have you ever had a reaction to a certain product/ingredient or to a skincare service?*

YesNo

If you answered yes to the above, please provide additional details:

Do you have any known allergies to cosmetics, food, or medication?*

Are you currently receiving skincare treatments from an esthetician?*

YesNo

Are you currently in the care of a dermatologist?*

YesNo

Are you currently or have you ever been on Accutane?*

YesNo

Are you currently pregnant or breastfeeding?*

YesNo

Please list any medications/supplements/collagen or protein powders you are taking regularly.*

On a scale of 1-10 (with 10 being the most!), how serious are you about your skincare journey? *

I offer in person and virtual consultations. The fee is $75 which includes your custom regimen recommendation and me as your virtual esthetician to guide you through the acclimation process + answer any questions you may have. A professional grade skincare regimen will vary in pricing depending on your concerns/goals. On average, these are going to range from $300-$500 and will last at least 3 months before needing repurchased. Should we contact you to set up a consultation?*

YesNo

Would you prefer an in person or virtual consultation?*

In PersonVirtual (FaceTime)

Are you interested in discussing in clinic treatment options? These would be performed by one of our estheticians, Elizabeth or Taylor, depending on availability!

YesNo, I am just interested in home care for now!Maybe

My esthetics approach is results driven and focused on helping my clients with their skin concerns & goals. I do this by building solid, custom home care routines specific to their goals which helps them maintain their results from in clinic treatments. This requires work on both ends, but the results are always worth it! Does this sounds like we would be a good fit?*

YesNo

Referrals are the best compliment I can receive. Is there anyone I can thank for referring you to my business?

Additional Comments/Questions:

New Client Waitlist-Skincare