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CLIENT FORMS

Initial Skincare Intake Form

Address
Have you had any of these facial hair removal services in the last 7 days?
Do you currently use: Accutane, Retin-A, Prescribed topical cream?
Have you received any chemical peels, laser services, or microdermabrasion treatments?
Yes, within the last month
Yes, within the last 2-3 months
No
We love to share spa experiences via images (still or moving) for marketing/training purposes, in-house, website, business social media sites. Names and information will not be published.
Yes, I'd love to share my spa experience and results!
Sure, if I can view them first!
No, Thank You
Are you taking birth control?
Yes
No
Are you pregnant or breast-feeding?
Yes
No
How did you hear about us?
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