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)
INTAKE FORM RESPONSES
IS THIS YOUR FIRST TIME RECEIVING A SERVICE AT FLESH?
no
HOW DID YOU HEAR ABOUT US?
mom
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?
4/13/21 regular facial, yes
BIRTHDATE MM/DD/YY
1/25/2003
TELL US ABOUT YOUR CURRENT SKIN CARE REGIMEN. WHAT PRODUCTS DO YOU USE?
cetaphil, tazorac, aczone
ARE YOU CURRENTLY USING ANY PRODUCTS WITH RETINOLS, AHA/BHA. OR ANY OTHER ACID?
yes
HOW OFTEN DO YOU USE THE PRODUCTS YOU LISTED ABOVE?
Only at Night
HAVE YOU SEEN A DERMATOLOGIST IN THE LAST SIX MONTHS? IF SO, WHY? WAS ANYTHING PRESCRIBED?
yes, tazorac aczone
LIST ANY MEDICATIONS AND SUPPLEMENTS YOU ARE CURRENTLY TAKING AND HAVE TAKEN IN THE LAST SIX MONTHS.
glycopyrrolate
HAVE YOU EVER TAKEN ACCUTANE? IF SO, LIST ALL DATES AND LENGTH OF TIME.
no
PLEASE LIST ALL ALLERGIES.
n/a
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?
never
WHAT ARE YOUR OVERALL SKIN CARE GOALS?
clear skin