• Your Appointment

    Please let us know when you are interested in scheduling an appointment. The more information you provide the better we can schedule a skin specialist that is right for your need. If you have any questions please ask your consultant, or email us at care@gorgeousgetaways.com
  • Are you combining this with another booking? If yes, indicate other treatments
  • Your Preferred Consultation Date
     - -

  • Note: we cannot guarantee the time of the appointment as it will depend on the hospitals capacity. 

  • Time of day

  • About You

  •  -

  • Your Skin

  • Areas of the body most concerned with
  • What are your skin care challenges? Select all that apply.*
  • Have you ever had a facial or skin treatment before?*
  • What Skin Care Products do you currently use? Select All that apply*

  • Please list the specific products (brand & product type/name) you are currently using so your skin specialist can best answer any questions on ingredients and help you meet your skin care goals.

  • Do you/have you used Retin-A, Renova, Adapalene, Accutane, Differen, Glycolic Acid, Lactic Acid, Mandelic Acid, Retinol, or other Vitamin A derivitives?*
  • Have you received any of these hair removal services in the last 30 days? Select All that Apply*
  • Have you ever received chemical peels, laser services, or microdermabrasion treatments? *
  • Have you received any Botox, Juvederm, or other dermal fillers in the last two weeks?*

  • Your Health

  • Have you experienced any of these health conditions in the past or present?*
  • Do you?*
  • Do you take any of the following dietary / health supplements?
  • Any known allergies?*
  • Have you used or been prescribed any medications (topical or oral) for acne / acne control?*
  • Are you a smoker? *
  • Do you drink more than 4 caffeinated beverages a day? (tea, coffee, soda, energy drinks)*
  • Have you ever experienced claustrophobia? *
  • Please rate your stress level*

  • FEMALE CLIENTS

  • Are you taking birth control? *
  • Are you pregnant or trying to become pregnant?*
  • Any menopause issues? *
  • Are you undergoing any hormone replacement therapy?

  • MALE CLIENTS

  • What is your current shaving system? *
  • Do you experience irritation from shaving? *
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