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Do you have any allergies? (If yes, please list below)
Yes
No
Have you ever taken Accutane? (If so, when?)
Yes
No
Have you had a peel or used any exfoliants within the last 48 hours?
Yes
No
Have you waxed, threaded or used hair removal creams within the last 48 hours?
Yes
No
Do you use sunscreen on a daily basis?
Yes
No
Are you currently pregnant or lactating?
Yes
No
Please choose which best describes your relationship with your skin:
I'm breaking out - PLEASE help!
My skin is always read or irritated.
Just trying to get rid of these wrinkles.
What are these dark spots on my face?
I'm new to the facial world.
All natural is the life for me.
Are you under the age of 18? If so please have a parent or guardian fill out the remainder of this form to give us permission to receive skincare services at The Oasis Facebar.
Yes
No
By submitting this form, I confirm that the answers above are correct and I have not withheld any information that may be relevant to my treatments at The Oasis Facebar
I Agree
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