Core Skin Studio - Model Form
Please only fill this form out if you are interested in being a model. You MUST be comfortable with photos and videos being taken and shared to be a model for marketing purposes.
Full Legal Name:
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First Name
Last Name
Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Date of Birth
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-
Month
-
Day
Year
Date
Social Media + Other Questions
Instagram Handle (put N/A if you do not have one)
*
I won't tag you (unless you want me to), but I do like to follow you!
Are you comfortable being tagged in content?
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Yes
No
Are you comfortable with sharing content on your own page?
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Yes
No
How did you hear about Core Skin Studio?
Instagram
Website
Referral
Facebook
Google
Other
Why do you want to be a model client for Core Skin Studio?
Skin + Treatment Goals
What are your main skin concerns?
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Examples: acne, aging, pigmentation, texture, hydration, soothing, etc.
How would you describe your skin type?
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Examples: dry, oily, combination, sensitive, acne-prone, etc.
What is your current skincare routine?
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Please include cleansers, toners, serums, exfoliators, moisturizers, etc.
Do you currently use any prescription skincare from a dermatologist/physician? Examples: Tretinoin, Hydroquinone, Steroid Creams, Anti-Fungal Creams, etc.
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Yes
No
If you answered "Yes" above, please list what you use.
Do you see another esthetician or get services done regularly? (can be monthly, bi-monthly, quarterly)
Yes
No
Do you currently do facial waxing regularly? (brows, upper lip, chin)
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Yes
No
Have you had any of these procedures done in in the last 2 years? Please check all that apply.
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Facials
Microneedling
Nanoneedling
Chemical Peels
Botox
Dysport
Filler
Sculptra
Cool Sculpting
Threads
Plastic Surgery
PRF
Laser (Moxi, BBL, etc.)
Laser Hair Removal
Threads
Permanent Makeup (brows, eyes, lips)
Treatment Interest
Which services would you be open to modeling for? (check all that apply)
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Facials
Acne treatment/extractions
Dermplane
Chemical peel
Microneedling
New or experimental services
Do you like to talk or relax during treatments?
I like to have conversations
I prefer more quiet/silent
Depends on the day
Medical History
Do you have any known allergies to ANYTHING (food, skincare, medications, animals/insects, metals, latex, etc.)
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Yes
No
If you answered "Yes" to the question above, please list allergies here:
Are you currently taking ANY prescription medications?
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Yes
No
If you answered "Yes" to the above question, please list medication(s) and reason(s) for medication
Example: "zoloft - anxiety/depression"
If you have been diagnosed with any autoimmune conditions, cancer (past/present), blood disorders, tumors (past/present), or any other more severe diagnoses, please list them here:
*
Please put NA if not applicable
Availability + Flexibility
Please pick based on the best option that fits your lifestyle :)
Day of the Week (check all that apply)
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Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Time of the Day (check all that apply)
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Mornings typically work best (9am-11:30am)
Afternoons typically work best (12pm-3:30pm)
Evenings typically work best (4pm-7pm)
I can be pretty flexible on time
Other
How much notice in time would you typically need?
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Are you comfortable with last-minute scheduling (less than 24 hours)?
Yes
No
Unsure, but you can always reach out to see
Comfort with Being On Camera
Are you comfortable being photographed?
Yes
No
Are you comfortable being filmed during treatments?
Yes
No
Consents + Expectations
I acknowledge that treatments may be discounted or complimentary in exchange for media/content use.
*
Yes
I give consent to Core Skin Studio LLC to use photos/videos taken during your modeling service for being used for any and all marketing, all applicable social media accounts, and website purposes.
Yes
I acknowledge that modeling services provided are designed for both treatment and content creation. As part of this, there may be brief interruptions, repositioning, or adjustments for lighting and filming purposes. I understand that the overall flow and timing of the treatment will differ from a traditional experience in the Studio.
Yes
Submit
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