Appointment Details
Keri Clarke
10-Dec-2021
PRE - Treatment Notes
AFTER REVIEWING THEIR CONSULTATION FORM, WHAT TREATMENT DO YOU RECOMMEND AND WHY?
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HOW HAS THE CLIENT'S SKIN BEEN SINCE THEIR LAST TREATMENT? WHAT EXACTLY DID THE CLIENT OBSERVE ABOUT THEIR SKIN?
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WHAT EXACT REGIMEN IS THE CLIENT CURRENTLY FOLLOWING DAILY? LIST ALL PRODUCTS.
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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?
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WHAT PRODUCTS DO YOU RECOMMEND FOR AT HOME USE?
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ADDITIONAL NOTES
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APPOINTMENT SUMMARY
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IS THIS YOUR FIRST TIME RECEIVING A SERVICE AT FLESH?
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HOW DID YOU HEAR ABOUT US?
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ARE YOU PREGNANT OR BREASTFEEDING?
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WHEN AND WHERE WAS YOUR LAST FACIAL SERVICE? WHAT TYPE OF SERVICE DID YOU RECEIVE? WERE YOU SATISFIED WITH YOUR RESULTS?
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BIRTHDATE MM/DD/YY
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TELL US ABOUT YOUR CURRENT SKIN CARE REGIMEN. WHAT PRODUCTS DO YOU USE?
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ARE YOU CURRENTLY USING ANY PRODUCTS WITH RETINOLS, AHA/BHA. OR ANY OTHER ACID?
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HOW OFTEN DO YOU USE THE PRODUCTS YOU LISTED ABOVE?
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HAVE YOU SEEN A DERMATOLOGIST IN THE LAST SIX MONTHS? IF SO, WHY? WAS ANYTHING PRESCRIBED?
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LIST ANY MEDICATIONS AND SUPPLEMENTS YOU ARE CURRENTLY TAKING AND HAVE TAKEN IN THE LAST SIX MONTHS.
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HAVE YOU EVER TAKEN ACCUTANE? IF SO, LIST ALL DATES AND LENGTH OF TIME.
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PLEASE LIST ALL ALLERGIES.
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DO YOU HAVE ANY RASHES, SKIN CONDITIONS, MEDICAL CONDITIONS, OR DISORDERS?
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WHAT TYPE OF DIET DO YOU FOLLOW?
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HOW OFTEN DO YOU MAKE BOWEL MOVEMENTS?
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DO YOU SMOKE?
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WHEN IS THE LAST TIME YOU DETOXED? WHAT TYPE OF DETOX DID YOU DO, AND FOR HOW LONG?
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WHAT ARE YOUR OVERALL SKIN CARE GOALS?
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