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WAITLIST / BOOK WITH ME
New Client Intake Form
First name
Last name
Email
Phone
Birthday
Gender
Male
Female
How did you hear about The Skin Enthusiast? Google, Instagram, Friend, Family? (please state the name of the person who referred you)
Which consultation are you looking to receive? All clients must begin with a consultation to discuss homecare and treatment plan. Consultations are paid by invoice before your consultation is booked. Are you looking for an appointment for in clinic treatment, virtual consultation, virtual acne bootcamp?
*
In Clinic Consultation + Treatment
In Clinic Consultation Only
Virtual Consulatation
Virtual Acne Bootcamp
Send
New Client Intake Form
First name
Last name
Email
Phone
Birthday 00/00/0000
1. Gender
*
Male
Female
2. How did you hear about The Skin Enthusiast? Google, Instagram, Friend, Family? (please state the name of the person who referred you)
3. Which consultation are you looking to receive? All clients must begin with a consultation to discuss homecare and treatment plan. Consultations are paid by invoice before your consultation is booked. Are you looking for an appointment for in clinic treatment, virtual consultation, virtual acne bootcamp?
*
In Clinic Consultation + Treatment
In Clinic Consultation Only
Virtual Consulatation
Virtual Acne Bootcamp
4. Are you looking to make treatments a monthly / regualr thing in order to meet your goals?
*
Yes, I am ready for a new home care regimen and to come in for monthly or frequent treatments
No, I just want a new home care routine
5. How much are you expecting to invest for your home care routine? I carry plenty of products to ensure I can work with almost any budget. My goal is to make sure your results and home care are easily obtainable for you. Keep in mind that a well rounded skin care regimen starts around $175
*
$0 - $175
$175 - $350
$350+
I am willing to invest in whatever you recommend to me to get started on a quality, results driven treatment plan + home care regimen
I am currently on a professional home care routine from my last ethetician and would like help making adjustments.
6. Preferred Date/Time to set up initial consulation. If you don't have a preferrence type " No Preferrence"
Submit
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We’ll get back to you shortly.
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