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Save time- complete your new client intake forms ahead of time.  

Facial Intake form

Please fill out the following form prior to your first FACIAL with Serendipity Wellness Studio.  also please complete if it has been over 1 year since your last facial with us, or have had any major health changes

Have you undergone any sugeries in the past year?
Are you under the care of a dermatologist?
Please check if you have ever had any of the following:
Are you allergic to aspirin?
Are you allergic to Aloe Vera?
Do you use Retin-A?
Have you ever used Accutane?
Do you have any implanted metal devices?
Do you smoke?
Do you have any allergies?
What types of skincare products are you currently using?
Are you achieving the desired results with your current beauty regimen?
Do you experience oily shine during the day?
Do you experience skin breakouts?
Do you take laxatives or diuretics?
Do you experience any of these skin conditions?
How many cups of caffeinated beverages do you drink daily?
Do you burn easily in moderate sunlight?
Do you take any diet pills or other stimulants?
Have you ever had a reaction to any of the following:
Have you ever experienced claustrophobia?
FEMALE CLIENTS ONLY: Are you taking oral contraception?
FEMALE CLIENTS ONLY: Are you pregnant or attempting?
FEMALE CLIENTS ONLY: Are you currently having or are due for your menstrual period?
MALE CLIENTS ONLY: What is your current shaving system?
MALE CLIENTS ONLY: Do you experience irritation from shaving?
MALE CLIENTS ONLY: Do you experience ingrown hairs?

Thanks for submitting! We are looking forward to seeing you!

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