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Skin Consultation Form Template

This document is a client consultation profile containing personal information, skincare profile, and after treatment record sections. It collects a client's name, contact details, date of birth, occupation, skin type, conditions, current skincare routine and brands used. It also includes a timetable to schedule follow up calls and visits 2 days, 2 weeks and 2 months after a facial treatment to record results and check for any allergic reactions or health issues. The client needs to agree to the recommended treatment by signing and dating the document.

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Safi abd rahman
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111 views2 pages

Skin Consultation Form Template

This document is a client consultation profile containing personal information, skincare profile, and after treatment record sections. It collects a client's name, contact details, date of birth, occupation, skin type, conditions, current skincare routine and brands used. It also includes a timetable to schedule follow up calls and visits 2 days, 2 weeks and 2 months after a facial treatment to record results and check for any allergic reactions or health issues. The client needs to agree to the recommended treatment by signing and dating the document.

Uploaded by

Safi abd rahman
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Client Consultation Profile

Part A : Personal Beauty Profile

Personal Information

Name : _______________________________________ Date : ____________________

Phone : _______________________________________ Birthday :__________________

Email Address : ____________________________________________________________

Occupation : __________________________ Referred Name : ____________________

I am interested in :
o Skincare know-how o Makeup techniques o Body care
o Latest trendy products o Business opportunity o Treatment Hair / Face / Body

Skincare Profile

1. My skin type is
o Dry o Normal o Oil o Combination

2. My skin condition is
o Acne o Sensitive o Aging o Pigmentation

3. My current skincare routine consist of products below


o Cleanser o Toner o Eyecare
o Moisturizer o Mask o Other special care
____________________
I am currently using mainly ______________________ brand skin care

Part B : After Treatment Record

Time table Date Records Referral


- make a call 2 days after the
Facial session
- pay a visit 2 weeks after the
Facial session
- pay a visit 2 months after the
Facial session
‘Remarks On Allergic / Health Issue :

……………………………………………………………………………………………………

I hereby agreed that I can proceed to the treatment recommended

………………………………………………………… Date :

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