Today's Appointments
Client History
Client Name
Date & Time

LEFT PROFILE PHOTO (BEFORE TREATMENT)

RIGHT PROFILE PHOTO (BEFORE TREATMENT)

AERIAL VIEW PHOTO (BEFORE TREATMENT)

CHIN/NECK VIEW PHOTO (BEFORE TREATMENT)

AFTER

AFTER

AFTER

AFTER
Past Appointment Notes
Date
AFTER REVIEWING THEIR CONSULTATION FORM, WHAT TREATMENT DO YOU RECOMMEND AND WHY?
-
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.)
-
WHAT TREATMENT DO YOU RECOMMEND TODAY AND WHY?
-
WHAT TREATMENT IS CLIENT AGREEING TO GET TODAY?
-
IS CLIENT INTERESTED IN PURCHASING A NEW PRODUCT REGIMEN TODAY?
-
HOW WILL WE REMEMBER THIS CLIENT? WHAT DID YOU LEARN ABOUT THEM?
-
WHAT PRODUCTS DO YOU RECOMMEND FOR AT HOME USE?
-
Additional Notes
-
Date
IS THIS YOUR FIRST TIME RECEIVING A SERVICE AT FLESH?
-
HOW DID YOU HEAR ABOUT US?
-
ARE YOU PREGNANT OR BREASTFEEDING?
-
WHEN AND WHERE WAS YOUR LAST FACIAL SERVICE? WHAT TYPE OF SERVICE DID YOU RECEIVE? WERE YOU SATISFIED WITH YOUR RESULTS?
-
BIRTHDATE MM/DD/YY
-
TELL US ABOUT YOUR CURRENT SKIN CARE REGIMEN. WHAT PRODUCTS DO YOU USE?
-
ARE YOU CURRENTLY USING ANY PRODUCTS WITH RETINOLS, AHA/BHA. OR ANY OTHER ACID?
-
HOW OFTEN DO YOU USE THE PRODUCTS YOU LISTED ABOVE?
-
HAVE YOU SEEN A DERMATOLOGIST IN THE LAST SIX MONTHS? IF SO, WHY? WAS ANYTHING PRESCRIBED?
-
LIST ANY MEDICATIONS AND SUPPLEMENTS YOU ARE CURRENTLY TAKING AND HAVE TAKEN IN THE LAST SIX MONTHS.
-
HAVE YOU EVER TAKEN ACCUTANE? IF SO, LIST ALL DATES AND LENGTH OF TIME.
-
PLEASE LIST ALL ALLERGIES.
-
DO YOU HAVE ANY RASHES, SKIN CONDITIONS, MEDICAL CONDITIONS, OR DISORDERS?
-
WHAT TYPE OF DIET DO YOU FOLLOW?
-
HOW OFTEN DO YOU MAKE BOWEL MOVEMENTS?
-
DO YOU SMOKE?
-
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?
-
Date
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.)
-
WHAT TREATMENT DO YOU RECOMMEND TODAY AND WHY?
-
WHAT TREATMENT IS CLIENT AGREEING TO GET TODAY?
-
HOW WILL WE REMEMBER THIS CLIENT? WHAT DID YOU LEARN ABOUT THEM?
-
WHAT PRODUCTS DO YOU RECOMMEND FOR AT HOME USE?
-
Additional Notes
-
Date
AFTER REVIEWING THEIR CONSULTATION FORM, WHAT TREATMENT DO YOU RECOMMEND AND WHY?
This is the therapist response field
AFTER REVIEWING THEIR CONSULTATION FORM, WHAT TREATMENT DO YOU RECOMMEND AND WHY?
This is the therapist response field
AFTER REVIEWING THEIR CONSULTATION FORM, WHAT TREATMENT DO YOU RECOMMEND AND WHY?
This is the therapist response field