Dermaplaning PreRegistration Form

Keeping Your Skin Glowing

We need to know this information in order to make sure that including dermaplaning to your treatment is safe and able to be performed.

First Name

Last Name

Do you use any form of retinol?

Have you used retinol within the past 60 days?

Have you had any exfoliation recently?

Are you pregnant or lactating?

Are you interested in learning about these?

Do you have allergies to any of these?

Current Skin Issues

What concerns do you have about your skin?