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Appointment  Details

Rochelle Simmons

03-Sep-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)

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POST - Treatment Notes

HOW WILL WE REMEMBER THIS CLIENT? WHAT DID YOU LEARN ABOUT THEM?

Children treated her to this facial for Mother’s Day. Finally got around to making her appt. has three children two adults and an 11 year old daughter. Son in military has two young children..daughter just had babygirl a few months ago. Both are under the age of 25. Son is married

WHAT PRODUCTS DO YOU RECOMMEND FOR AT HOME USE?

Glowing love kit..already uses br soap and astringent

ADDITIONAL NOTES

Gets organic products from Venus advised her not to use br as toned but more as spot treatment. Has beautiful skin with a few dark marks. Rec going dairy free for 2montgs gave card with QR code. Rec a good couples therapist for art and I to try

APPOINTMENT SUMMARY

View Entire History

IS THIS YOUR FIRST TIME RECEIVING A SERVICE AT FLESH?

yes

HOW DID YOU HEAR ABOUT US?

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?

I don’t recall - it’s been years.

BIRTHDATE MM/DD/YY

8/7/1980

TELL US ABOUT YOUR CURRENT SKIN CARE REGIMEN. WHAT PRODUCTS DO YOU USE?

Burdock root soap and astringent, and vitamin E oil

ARE YOU CURRENTLY USING ANY PRODUCTS WITH RETINOLS, AHA/BHA. OR ANY OTHER ACID?

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.

Codeine

DO YOU HAVE ANY RASHES, SKIN CONDITIONS, MEDICAL CONDITIONS, OR DISORDERS?

No

WHAT TYPE OF DIET DO YOU FOLLOW?

I eat meat and dairy products

HOW OFTEN DO YOU MAKE BOWEL MOVEMENTS?

Few times a week

DO YOU SMOKE?

no

WHEN IS THE LAST TIME YOU DETOXED? WHAT TYPE OF DETOX DID YOU DO, AND FOR HOW LONG?

I haven’t

WHAT ARE YOUR OVERALL SKIN CARE GOALS?

Clear/glowing skin

Intake Form

Product Purchases

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