Returning Client Update Form

Returning Client Update Form
Welcome Back!

Thank you for trusting us with your skin again.

Please complete this required form PRIOR to your appointment. Failure to do so may impact your time in treatment.

To ensure your treatments are safe, effective, and tailored to your skin’s needs, it’s important that we have current and accurate information about any medications, skincare products/treatments, allergies, or health conditions.

All information provided is strictly confidential and used solely for treatment purposes.

Please allow 5-10 minutes to complete this form.

Thank you!
Today's Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Full Name

First NameLast Name
Email Address
example@example.com
Cell Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Have you developed any new allergies since your last visit? Please list them below.
Are you taking any new medications or supplements? Please specify.
Have you experienced any new skin conditions or sensitivities?
Have you received any of the following skin treatments since your last appointment? (Select all that apply)

Other
If you selected any treatments above, please provide details below:
Have you had any facial waxing in the last 5-7 days?
Have you been diagnosed with any new medical conditions?
What are your current skincare goals or concerns?
Is there anything else you would like your esthetician to know?
I have reviewed and agree to the following clinic policies:
By signing below, I acknowledge and agree to the policies outlined above and here.

Please review the full Client Policies & Care Agreements here:

View Full Policies
Client Signature ~ Consent to all policies
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty: