SKIN QUESTIONS

Please fill out the following form.

First name

Last name

Email

Is there anything medical I need to know before you have your treatment? If yes, please write below

Do you have any allergies?

Yes

No

Have you had any Botox or filler in the last two weeks?

Are you pregnant? If yes are you past your first trimester

Are you going through fertility treatment? If yes please let me know where about your up to with your treatment.

Are you taking any medication?

What is the main skin concern you would like me to focus on today?

What is your skincare routine?

Do you need help with a skincare routine?

Yes

No