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Appointment  Details

Janika Johnson

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?

Breakout from dairy noticed rash across...forehead and dairy..stopped 3 week ago

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

Br soap pretty girl melanin toner.. sample pac azelac... better together ... aglicolic 1 to two a week... scrub once a week..texture is smoother natural glow not as dry products are absorbing better

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

Add azelac ru to regimen

IS CLIENT INTERESTED IN PURCHASING A NEW PRODUCT REGIMEN TODAY?

WHAT TREATMENT IS CLIENT AGREEING TO GET TODAY?

Chemical Peel

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?

Birthday is 4/23/21. Going to dinner, brunch and a pottery class.

WHAT PRODUCTS DO YOU RECOMMEND FOR AT HOME USE?

azelac ru as soon as we have it in stock

ADDITIONAL NOTES

very passionate about civil rights and political unrest

APPOINTMENT SUMMARY

Product Purchases

Date
List of products
Submit
View Intake Form

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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