Appointment Request & New Patient Application

  • Appointment Request & New Patient Application

  • I acknowledge that my appointment is not confirmed until I receive a confirmation from the clinic, and that a staff member will call me to collect additional information for the appointment or if my preferred times are unavailable.

  • Please select the treatment you are interested in: (Select all that apply)*

  • Price for Botox/Dysport: $15 per unit 

  • Price for Lip Filler: $800 per session

    *Lip Filler is priced per session not the amount of filler

  • Price for Filler: $800-$900 per syringe depending on the area  

  • *Facial Balancing can be a combination of treatments. A Consulation is required to review your goals and create a customized treatment plan and for accurate pricing

  • Price for SkinPen Microneedling: $450 per session 

    Price for SkinPen Microneedling w/ PRF: $650 per session 

    Price for SkinPen Microneedling w/ Exosomes: $800 per session 

    Price for SkinPen Microneedling w/ Vamp: $800 per session 

    Neck Add on: $150 per session 

    *Package pricing available

  • Price for Potenza RF microneedling: $1000 per session 

    Neck add on: $350 per session  

  • Price for CO2 Lite/CoolPeel: $750 per session 

    Price for Fractional CO2: $1000 per session 

    *Session pricing includes Face and Neck 

  • Price for VI Peel: $350 per session 

    *Package pricing available

  • Price for BioRePeel: $225 per session 

    *Package pricing available

  • Price for PRF Hair Therapy: $500 per session

    *Package pricing available

  • Price for PRF Gel One Area: $800 per session

    Price for PRF Gel Full Face: $1250 per session

    *Package pricing available

  • Price for PRF Liquid One Area: $500 per session

    Price for PRF Liquid Full Face: $800 per session

    *Package pricing available

  • Price for Dissolving Filler: $250 per vial 

  • Price for Kybella: $600 per vial 

    *package pricing available 

  • Consulation Fee is $100

  • Virtual Consulation Fee is $100

    *Fee for virtual consulation may be applied towards the treatment, if treatment is completed within 30 days of your virtual consualtion

  • Clinical Safety

    Evaluation of Previous Work:

    To ensure the safest and most aesthetic outcome, your provider will evaluate the treatment area for any irregularities, such as lumps, product migration, or overfilling from previous treatments.

    Requirement to Dissolve: If irregularities are found, we require the area to be dissolved and fully healed before we can safely proceed with a new treatment.

    Medical Records: To move forward with a dissolving treatment, we require official medical records from your previous provider identifying the specific product used.
    Next Steps: Please request these records from your previous provider and email them to info@allumineskin.com prior to your appointment.

  • Medical Records: To move forward with a dissolving treatment, we require official medical records from your previous provider identifying the specific product used.
    Next Steps: Please request these records from your previous provider and email them to info@allumineskin.com prior to your appointment.

  • Format: (000) 000-0000.
  • Are you an existing patient or a new patient?

  • As an existing patient you may also text us at (925)558-9832 to schedule an appointment.

  • Please provide preferred times for your appointment

  • Availability
    While we always do our best to accommodate your requested dates, booking sooner rather than later is always best—especially if you have a special event coming up. Please keep this timeframe in mind when selecting your preferred windows.

    Are you a Bride-to-Be?
    To ensure you achieve your ultimate aesthetic goals for your big day, we recommend a consultation 6 months to 1 year in advance. This timeframe is crucial as it allows our team to design a personalized treatment plan and ensures your skin and results are perfectly "camera-ready" without the stress of last-minute healing or adjustments

     

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  • Consultation Policy & Fee Acknowledgement

    Initial Consultation Requirement

    To provide the highest standard of care, all new patients at Allumine Skin Clinic begin with a comprehensive consultation. This allows our providers to understand your aesthetic goals, review your medical history, and create a customized treatment plan tailored to your needs.

    Consultation Fee Details

    • Fee: The consulation fee is $100
    • Treatment Credit: If you choose to proceed with a treatment on the same day as your consultation, the $100 fee will be applied toward the cost of your treatment.
    • Non-Refundable & Non-Transferable. The fee is non-transferable to a different date or time if you choose not to proceed with treatment on the day of your initial consultation.
    • If you elect not to receive treatment during your scheduled visit, the fee covers the provider's professional time and clinical assessment.

  • Media Consent & Photo Policy

    Commitment to Clinical Excellence

    At Allumine Skin Clinic, we take pride in the transformative results we achieve with our patients. To document your progress and share the efficacy of our treatments with our community, we require all patients to participate in our photo sharing policy

    Consent Requirements

    By becoming a patient at Allumine Skin Clinic, you agree to the following:

    Mandatory Photography: You consent to have high-resolution "Before & After" photos and videos taken of your treatment area for your clinical record.
    Minimum Sharing Requirement: You agree to allow the clinic to share at least partial-face images or videos (focused on the treatment area) on our social media platforms and marketing materials.

    For examples of partial face photo sharing we invite you to visit our instagram page @allumineskin.clinic to view examples of full face and partial face photo sharing.

  • Cancellation Policy

    To finalize and reserve your appointment time, Allumine Skin Clinic requires a valid credit or debit card to be held on file.

    • 48-Hour Notice: We value our providers' time and our patients' schedules. We require a minimum of 48 hours' notice for any cancellations or changes to your appointment.
    • Late Cancellation & No-Show Fee: Any reschedules, cancellations, or no-shows occurring within the 48-hour window will result in a non-refundable $100 charge to the card on file.

    Finalizing Your Reservation

    Payment Information & Confirmation

    To protect our schedule and your requested time, Allumine Skin Clinic requires a valid credit card to be held on file for all appointments.

    • The Follow-Up: Once our team has reviewed your intake and identified an available time, a staff member will contact you via phone to securely collect your credit or debit card information.
    • Final Status: Please be advised that your appointment is not officially confirmed until your card information has been successfully added to your secure patient profile. Once the card is on file, you will receive a final confirmation notice via email.

  • Final Review & Next Steps


    Before you submit your request, please review the following:

    Request Status:

    By clicking submit, you are sending an appointment request. This is not an instant booking. Your appointment is only confirmed once you receive a separate confirmation notice from our office.

    New Patient Outreach:

    If you are a new patient, a member of the Allumine team will contact you shortly via phone. During this call, we will:

    • Verify your treatment goals and clinical information.
    • Discuss alternative times if your preferred window is unavailable.
    • Collect your credit/debit card information to securely finalize your reservation and uphold our cancellation policy.

    Ready to move forward? Click the button below to send your request to our team. We look forward to speaking with you!


     

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