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Appointment  Details

Yaniery Cabrera

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?

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

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?

Chem 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?

Skin looks really good. Mother in law lost battle with cancer this summer. Husband is burying himself in work. Hasn’t sought a grievance counselor yet..no interested in the moment. Daughters’ bdays are coming up in December. Oldest wants a virtual reality game youngest is unsure. Oldest is trying her hand at basketball frustrated she p

WHAT PRODUCTS DO YOU RECOMMEND FOR AT HOME USE?

ADDITIONAL NOTES

..frustrated she’s not great at it but is persevering. Working from home now..loves the set up. Likes Littke Allen’s Steak house

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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