Art of Skin Care - Acne Consult

Client Information

Welcome to our Acne Coaching Program! Please fill this form out with as much detail as possible. It is very important for us to get answers to every question in order to help you achieve the best results.

First name *

Last name *

Email *

Ethnicity

Age

Gender Identification

Were you assigned a different gender?

Art of Skin Care - Acne Consult

Grooming

Describe any facial hair removal methods

Do you use shaving cream, if so which one

If shaving, what type of razor

Do you have shaving irritation?

Art of Skin Care - Acne Consult

Current Skin Care Regimen

Reaction to products (ours, others)?

If yes, list product and reactions

For the next section it is very important that you type out your routine. Please do not copy and paste a past answer or routine, make sure you list your current steps exactly.

List AM Regimen with specific products

List PM Regimen with specific products

Describe makeup use (include types)

Sunscreen use, which product, how often?

Additional products you may be using

List your haircare products and brands:

Any products you would like to replace?

If you are running low on any products you would like to replace, list them here.

Any treatments you've had in 90 days

Chemical Peels
Dermabrasion
Electrolysis
Facial Waxing
Laser Hair Removal
Laser Rejuvenation/Resurfacing
Microdermabrasion
Skin Cancer Removal

When and where did you get the treatment

Art of Skin Care - Acne Consult

Preferences

Product Reference

Protocol Preference

Which brand would you like to work with?

Another brand you would like to use:

How did you hear about us?

Art of Skin Care - Acne Consult

Upload Photos

Please upload at least three photos (preferably one of each side, and one straight on). The photos must be close enough for us to see the details of your skin. We recommend taking a photo outside or in your car during the morning hours for the best lighting! This is a required field.

Attachments

Choose file or drag here

Supported format: JPG, JPEG, PNG, GIF, SVG.

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You’re One Step Closer to Clear Skin!

Thank you for completing your acne consultation form! Your personal acne specialist is reviewing your file and will email you with expert recommendations within 2 to 3 business days.

We’re excited to support you on your journey to clear, healthy skin!

You’re One Step Closer to Clear Skin!

Thank you for completing your acne consultation form! Your personal acne specialist is reviewing your file and will email you with expert recommendations within 2 to 3 business days.

We’re excited to support you on your journey to clear, healthy skin!

Art of Skin Care - Acne Consult

Art of Skin Care - Acne Consult

For the following question, select all that apply.

Art of Skin Care - Acne Consult

Art of Skin Care - Acne Consult

Art of Skin Care - Acne Consult

For the next section it is very important that you type out your routine. Please do not copy and paste a past answer or routine, make sure you list your current steps exactly.

Art of Skin Care - Acne Consult

For the following question, select all that apply. On desktop, you can hold down control + click to multi-select

Art of Skin Care - Acne Consult

For the following questions, select all that apply.

Art of Skin Care - Acne Consult

Art of Skin Care - Acne Consult

Pinus Cembra Wood Extract

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