Cosmetic Procedure Questionnaire
All information is held strictest confidence. At no given point is information disclosed or shared without client’s written consent. You may choose to skip answering any question you feel impinges on personal information you do not wish to disclose.
Your Health
Female Clients Only:
Male Clients Only
Our lasers, IPL and chemical peel selections and procedures are based off of your skin type; in order for you to achieve optimal results. Please fill out the following information so we can properly asses and safely treat your Skin Type.
Fitzpatrick Skin Type Quiz
Please circle the score that most closely applies to you and calculate
the numbers at the bottom of each column:
Genetic Disposition