Birthday

Are you currently under the care of a doctor for any medical conditions?

Are you currently pregnant or breastfeeding? (Some treatments may not be safe during pregnancy.) *

Do you have any skin conditions or sensitivities? (E.g., eczema, psoriasis, acne, rosacea)*

Do you have any history of skin reactions to products or treatments?*

Do you have any history of skin reactions to products or treatments?*

Are you currently using any skin medications or treatments? (For example, Retinol, Accutane, etc.)*

Do you use any treatment or products at home (cleanser, toner, serum, eye-cream, day/night cream, SPF) ?

Do you have a history of using medication that affects your skin?

How often do you use skincare products at home?

Do you have any habits that might affect your skin? (E.g., smoking, sun exposure, lack of sleep, diet)

Do you wear makeup regularly? (Some treatments may need to consider makeup removal or how to handle products.)

How did you hear about us?

Do you consent to the therapist performing the treatments booked?*

Do you understand and accept the risks involved with certain treatments (e.g., peel, microneedling)?*

Do you consent to having photographs taken for your treatment record and / or marketing?*

Would you like to be contacted for future promotions or appointments?*