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5/20/21, 2:00 PM
Jewel

Terry Belton

This is the client's first visit in over a year! 

Overview of Last Appointment

Date & Time

THIS IS THE CLIENT'S FIRST VISIT! LET'S MAKE IT ONE TO REMEBER! 

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)

 Today's Session:

20-May-21
View Today's Appointment Notes

PRE - Treatment Notes
Upload BEFORE Photos
Input Notes for RETURNING Clients
Input Notes for NEW Clients
POST - Treatment Notes
Upload AFTER Photos
Input POST-Treatment Notes
Log Purchases

INTAKE FORM RESPONSES

IS THIS YOUR FIRST TIME RECEIVING A SERVICE AT FLESH?

yes

HOW DID YOU HEAR ABOUT US?

Owner

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?

5 yrs ago

BIRTHDATE MM/DD/YY

3/21/1974

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

I wash my face nightly with kiehls facial wash moisturize wuth neutrogena rapid wrinkle release and also use avocado cream from keihls around my eyes for puffy and dry spots

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

Yes neutrogena

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.

Albuterol prednisone cats claw. Theamine cascara segrada probiotic prebiotic

HAVE YOU EVER TAKEN ACCUTANE? IF SO, LIST ALL DATES AND LENGTH OF TIME.

No

PLEASE LIST ALL ALLERGIES.

Animals pollen dust

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

Eczema

WHAT TYPE OF DIET DO YOU FOLLOW?

I eat meat and dairy products

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?

Idk

WHAT ARE YOUR OVERALL SKIN CARE GOALS?

Even skin tone no puffy eyes ckear skin

Appointment History

Jewel

VIEW ALL APPTS

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