Name
First Name
Last Name
Date of Birth
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Day
Year
Date
What are your goals for your facial today?
Have you ever had any chemical peels, laser resurfacing, microdermabrasion or laser hair removal? If so, when?
Have you had any spa treatments done in the past two weeks? This includes waxing, botox, fillers etc.
What does your at home skincare routine look like?
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Do you have any allergies?
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