Bridal Inquiry

First name

Last name

Phone

Do you have any of the following skin conditions? (eczema, psoriasis, dermatitis, rosacea, acne, cold sores, sunburn, open wounds, active infections)

Do you have any known allergies? (ingredients, essential oils, nuts, latex, etc.)

Are you currently pregnant or breastfeeding?

Are you currently taking any medications (especially Accutane, steroids, antibiotics, retinoids)?

Have you been treated for cancer or are you currently undergoing chemotherapy or radiation?

Do you have any chronic illnesses (e.g., diabetes, autoimmune diseases) that affect your skin’s healing?

How would you describe your skin? (oily, dry, combination, sensitive, normal)

What are your main skin concerns? (acne, dryness, fine lines, hyperpigmentation, sensitivity, other)

What products are you currently using on your skin? (cleanser, exfoliants, retinol, vitamin C, sunscreen, etc.)

Have you ever had an adverse reaction to a facial, peel, or skincare product?

Do you have a history of cold sores? (important for peels or aggressive exfoliation)

Have you had any of the following in the last 2–4 weeks? (chemical peels, microdermabrasion, laser treatments, Botox/fillers, waxing, tanning, dermaplaning)

Have you recently started any new skincare products?

How much water do you drink daily?

How much sleep do you usually get per night?

Do you wear sunscreen daily?

Do you smoke or use nicotine?

Do you agree to follow post-care instructions and avoid contraindicated activities after your facial?

Yes

Do you consent to receive today’s facial service?

Yes