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Client Information Update Form

Client Information Update Form

Have any of the following changed since we last saw you?
Recently received a vaccine?
Dental Work? (recent or pending)*
New Medications?
Using new skin care products?
Recent or upcoming injections (Botox or filler)?
Taken Advil, Aspirin, or blood thinners in the last 24 hours?
Cold sores without pre-medications?
Currently pregnant or breastfeeding?
Upcoming trip to a sunny destination?
I consent to my likeness in the form of pictures or video for marketing purposes
I acknowledge that I have answered all questions truthfully and completely.
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