Appointment Details
Kim Blue
04-Aug-21
PRE - Treatment Notes
AFTER REVIEWING THEIR CONSULTATION FORM, WHAT TREATMENT DO YOU RECOMMEND AND WHY?
HOW HAS THE CLIENT'S SKIN BEEN SINCE THEIR LAST TREATMENT? WHAT EXACTLY DID THE CLIENT OBSERVE ABOUT THEIR SKIN?
WHAT EXACT REGIMEN IS THE CLIENT CURRENTLY FOLLOWING DAILY? LIST ALL PRODUCTS.
WHAT CHANGES WOULD YOU RECOMMEND NEED TO BE MADE TO THEIR REGIMEN IF ANY? (ADDITIONAL PRODUCTS, REDUCE USAGE OF A SPECIFIC PRODUCT ETC.)
IS CLIENT INTERESTED IN PURCHASING A NEW PRODUCT REGIMEN TODAY?
WHAT TREATMENT IS CLIENT AGREEING TO GET TODAY?
LEFT PROFILE PHOTO (BEFORE TREATMENT)
RIGHT PROFILE PHOTO (BEFORE TREATMENT)
AERIAL VIEW PHOTO (BEFORE TREATMENT)
CHIN/NECK VIEW (BEFORE TREATMENT)
LEFT PROFILE PHOTO (AFTER TREATMENT)
RIGHT PROFILE PHOTO (AFTER TREATMENT)
AERIAL VIEW PHOTO (AFTER TREATMENT)
CHIN/NECK VIEW (AFTER TREATMENT)
POST - Treatment Notes
HOW WILL WE REMEMBER THIS CLIENT? WHAT DID YOU LEARN ABOUT THEM?
WHAT PRODUCTS DO YOU RECOMMEND FOR AT HOME USE?
ADDITIONAL NOTES
APPOINTMENT SUMMARY
IS THIS YOUR FIRST TIME RECEIVING A SERVICE AT FLESH?
no
HOW DID YOU HEAR ABOUT US?
Referred
ARE YOU PREGNANT OR BREASTFEEDING?
no
WHEN AND WHERE WAS YOUR LAST FACIAL SERVICE? WHAT TYPE OF SERVICE DID YOU RECEIVE? WERE YOU SATISFIED WITH YOUR RESULTS?
May 2021, FLESH Skin Studio
BIRTHDATE MM/DD/YY
11/12/1980
TELL US ABOUT YOUR CURRENT SKIN CARE REGIMEN. WHAT PRODUCTS DO YOU USE?
Beauty counter
ARE YOU CURRENTLY USING ANY PRODUCTS WITH RETINOLS, AHA/BHA. OR ANY OTHER ACID?
Serum, essence, day/night cream
HOW OFTEN DO YOU USE THE PRODUCTS YOU LISTED ABOVE?
Every Morning and some nights
HAVE YOU SEEN A DERMATOLOGIST IN THE LAST SIX MONTHS? IF SO, WHY? WAS ANYTHING PRESCRIBED?
No
LIST ANY MEDICATIONS AND SUPPLEMENTS YOU ARE CURRENTLY TAKING AND HAVE TAKEN IN THE LAST SIX MONTHS.
N/A
HAVE YOU EVER TAKEN ACCUTANE? IF SO, LIST ALL DATES AND LENGTH OF TIME.
No
PLEASE LIST ALL ALLERGIES.
Kefkax/sulfa
DO YOU HAVE ANY RASHES, SKIN CONDITIONS, MEDICAL CONDITIONS, OR DISORDERS?
No
WHAT TYPE OF DIET DO YOU FOLLOW?
Pescatarian (I eat seafood AND dairy), Plant Based- I'm primarily Vegan but occasionally consume small amounts of meat/seafood and dairy
HOW OFTEN DO YOU MAKE BOWEL MOVEMENTS?
At least once a day
DO YOU SMOKE?
no
WHEN IS THE LAST TIME YOU DETOXED? WHAT TYPE OF DETOX DID YOU DO, AND FOR HOW LONG?
March
WHAT ARE YOUR OVERALL SKIN CARE GOALS?
Age gracefully and keep skin healthy