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Appointment  Details

Mica Whitfield

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?

Going through some things. darkness around mouth and raw acid mantle along above lips. Gets excema or dry patches around mouth occasionally. Recommended be mindful of diet or stress levels nest time it flares up

WHAT EXACT REGIMEN IS THE CLIENT CURRENTLY FOLLOWING DAILY? LIST ALL PRODUCTS.

br soap, br astringent and derma e moist..alternates between rosehip oil and derma e vit c moist.

WHAT CHANGES WOULD YOU RECOMMEND NEED TO BE MADE TO THEIR REGIMEN IF ANY? (ADDITIONAL PRODUCTS, REDUCE USAGE OF A SPECIFIC PRODUCT ETC.)

br soap, factor g moist and rosoil mask

IS CLIENT INTERESTED IN PURCHASING A NEW PRODUCT REGIMEN TODAY?

WHAT TREATMENT IS CLIENT AGREEING TO GET TODAY?

purifying facial

LEFT PROFILE PHOTO (BEFORE TREATMENT)

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RIGHT PROFILE PHOTO (BEFORE TREATMENT)

AERIAL VIEW PHOTO (BEFORE TREATMENT)

CHIN/NECK VIEW (BEFORE TREATMENT)

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LEFT PROFILE PHOTO (AFTER TREATMENT)

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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?

has very oily nose, sensitive cheeks, and compromised acid mantle around her mouth with dark marks on both sides of mouth

WHAT PRODUCTS DO YOU RECOMMEND FOR AT HOME USE?

factor g moist and rosoil mask

ADDITIONAL NOTES

want to get her skin peel ready..once skinis healed switch her over to better toghether kit azelac ru serum and mandelic scrub or boost the radiance with aglicolic ampuoles actually..then do a series of peel

APPOINTMENT SUMMARY

Product Purchases

Date
List of products
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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?

WHAT ARE YOUR OVERALL SKIN CARE GOALS?

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Intake Form
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