CLIENT INFORMATION

SECTION 1 — PRIMARY SKIN GOALS 

SECTION 2 — CURRENT SKIN CONCERNS

SECTION 3 — CURRENT SKINCARE ROUTINE 

List the products you currently use (brand if known)

AM ROUTINE

PM ROUTINE

SECTION 4 — MEDICAL & TREATMENT HISTORY 

SECTION 5 — LIFESTYLE FACTORS 

SECTION 6—EXPECTATIONS & COMMITMENT 

What results matter most to you in 3 months?