AniseCharles Consultation
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First Name
Last Name
Email
example@example.com
What do you need assistance with?
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Skin Care
Hair Care
Total Body Health
Health Coaching
What are your desired results?
Do you have any allergies?
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No
If yes, please explain
Are you currently on any medication? If yes list them.
Do you have any health issues I should be aware of?
What products are you interested in? List them.
*Disclaimer*- Before providing any service understand that I'm not a physician, i encourage you that upon receiving the products please test in a small area, or take small amounts, if you should feel any discomfort discontinue use and consult your physician.
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