Esthetician Intake Form Pdf

Esthetician Intake Form Pdf - ☐ male ☐ female ☐ other. Web what type of skin do you have? Web client consultation—esthetician your health 1) have you been under the care of a physician, dermatologist or other medical professional within the past year? Chemical peel botox microderm yes no adapalene differin. Have you had any of the following? (please check all that apply.) ☐breakouts/acne ☐blackheads/whiteheads ☐uneven skin tone ☐sun damage ☐excessive oil/shine ☐wrinkles/fine lines ☐dull/dry skin ☐rosacea ☐broken capillaries ☐redness/ruddiness ☐dehydrated ☐sun, liver,. Web esthetician client intake form disclaimer: _____ date:_____ associated skin care professionals member client consultation—continued. Web esthetician client intake form zip code no first name address email full name full name last name client information date of birth city preferred phone number gender.

I have not used a peel, exfoliated, or tanned in the last 72 hours. No yes, please explain:_____ 2) have you had any of the following conditions in the past or present? This esthetician client intake form is designed for practicing estheticians to provide to their new clients. I do not use a prescription acne mediation (such as accutane or have discontinued its use for at least 12 months. Web who can use this printable esthetician client intake form (pdf)? _____ date:_____ associated skin care professionals member client consultation—continued. ☐breakouts/acne ☐blackheads/whiteheads ☐uneven skin tone ☐sun damage ☐excessive oil/shine ☐wrinkles/fine lines ☐dull/dry skin ☐rosacea ☐broken capillaries ☐redness/ruddiness ☐dehydrated ☐sun, liver,. Web yes accutane vitamin c no retin a/stiva a tretinoin/avita isotretinion scrub/peel other prescription topical skin products. (please check all that apply.) It also asks if the client has any medical conditions that might be affected during or after the cosmetic or skin treatment.

Web client consultation—esthetician your health 1) have you been under the care of a physician, dermatologist or other medical professional within the past year? No yes, please explain:_____ 2) have you had any of the following conditions in the past or present? Web esthetician client intake form disclaimer: Web what type of skin do you have? Web who can use this printable esthetician client intake form (pdf)? Chemical peel botox microderm yes no adapalene differin. (please check all that apply.) This form is used to collect information about new clients and used for internal purposes only. The specialties of the professionals using this template could include: _____ date:_____ associated skin care professionals member client consultation—continued.

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Web What Type Of Skin Do You Have?

This esthetician client intake form is designed for practicing estheticians to provide to their new clients. Web client consultation—esthetician your health 1) have you been under the care of a physician, dermatologist or other medical professional within the past year? ☐ normal ☐ oily ☐ dry ☐ combination what areas of concern do you have regarding your skin? I do not use a prescription acne mediation (such as accutane or have discontinued its use for at least 12 months.

The Specialties Of The Professionals Using This Template Could Include:

_____ date:_____ associated skin care professionals member client consultation—continued. I have not used a peel, exfoliated, or tanned in the last 72 hours. The information you provide is confidential and will be treated accordingly. Chemical peel botox microderm yes no adapalene differin.

Web Esthetician Client Intake Form Disclaimer:

This form is used to collect information about new clients and used for internal purposes only. Web yes accutane vitamin c no retin a/stiva a tretinoin/avita isotretinion scrub/peel other prescription topical skin products. No yes, please explain:_____ 2) have you had any of the following conditions in the past or present? Web esthetician client intake form zip code no first name address email full name full name last name client information date of birth city preferred phone number gender.

Have You Had Any Of The Following?

☐breakouts/acne ☐blackheads/whiteheads ☐uneven skin tone ☐sun damage ☐excessive oil/shine ☐wrinkles/fine lines ☐dull/dry skin ☐rosacea ☐broken capillaries ☐redness/ruddiness ☐dehydrated ☐sun, liver,. Waxing consent please initial the following: (please check all that apply.) ☐ male ☐ female ☐ other.

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