The Skin Maven
Los Gatos Aesthetician of 40+ years practice - Deborah Berry.
We’re Here to Help You Find Your Best Skin!
We’ll ask a series of questions all about you so we can formulate your personalized skin care routine at your initial session.
Full Name
*
First Name
Last Name
Phone Number
*
Format: (000) 000-0000.
E-mail
example@example.com
How would you describe your skin?Choose one of the options below.
Normal
Dry
Oily
Combination
I don't know
Let us help identify your skin type!
Select the option that best describes your skin.
My skin usually feels dry and tight.
My skin usually feels greasy and can often look shiny
My skin usually feels soft and comfortable.
My skin feels greasy in the T-zone area, but the rest feels fairly dry/normal.
How visible are your pores?
Small pores that are not that visible
Large pores that are very visible
I don't see any pores
The pores are larger on my forehead, nose and jaw, but normal in the rest of the face
How does your skin feel in the afternoon?
My skin usually feels dry and tight
My skin usually feels greasy and can often look shiny
My skin feels normal, no major problems
My skin feels greasy in the T-zone area but the rest feels fairly dry/normal
How often do you get spots or blemishes?
Every day or weekly
About once a month
Every now and then, but most often on the forehead, nose or chin area
Other (please share at initial consultation).
How does your skin feel when you first wake up in the morning?
My skin usually feels dry and tight
Greasy and pores are visible around the face
Soft and good
T-zone feels normal but cheek areas are dry and tight
Please share your general availability so I can assist you with booking your initial session time that suits your schedule. (You may select multiple options!)
Monday mornings
Monday afternoons
Tuesday mornings
Tuesday afternoons
Wednesday mornings
Wednesday afternoons
Thursday mornings
Thursday afternoons
Friday mornings
Friday afternoons
How did you hear about my services?
*
Please Select
Newspaper
Internet
Magazine
Other
Please Specify
*
Please give reference of any two people whom you feel could benefit from my services:
Rows
Full Name
Address
Contact Number
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2
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