Client Skin Profile

Personal Information
Contact Information
1) How are you caring for you skin?
2)Have you ever had a professional facial before?
3)Are you currently, or within the last year, under a physicians care?
4)Have you undergone any surgery in the last 9 months?
5)Please define any health problems (past or present):
6)Do you have any metal pins, devices, etc. in your body?
7)Are you using Retin-A?
8)Please list all medications and vitamins that you are taking regularly:
9)Do you have any special skin problems?
10)Do you smoke?
11)How much water do you consume daily?
12)Have you ever experienced any claustrophobia?
13)Have you ever experienced sinus or allergy problems?
14)Do you prefer a massage to be firm or light in pressure?
15)Do you take any
16)Do you have any known allergies?

Thank you for your cooperation and enjoy your salon treatment!