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  • brinejad

Online questionnaires, rentals, and consent forms:

Initial Client Questionnaire:

All clients are required to fill out an online questionnaire and consent form (which will be kept confidential and secure) before their first appointment. This allows me to safely perform your service, tips me off to medical conditions or allergies that may affect your skin, and helps me focus on how to best treat your skin for optimal results. To fill out this form please follow this link:


Covid Questionairre:

Please fill out the following Covid form prior to your first appointment with me:


Rental Form:

Interested in a rental for a skincare device? This is the form you will be required to fill out.


For Remote Clients:


Please fill out this form for online/phone consultations:



To purchase a remote facial kit, I ask that you fill out the following questionnaire (just once is fine, to repurchase just let me know via text/email if anything has changed):





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