Get In Order To Provide You With The Most Appropriate Laser Treatment, We Need You To Complete The

Completing the necessary questionnaire is essential for ensuring you receive the right laser treatment tailored to your needs. This guide provides you with comprehensive, step-by-step instructions to fill out the form accurately and efficiently.

Follow the steps to complete the online form successfully.

1. Press the ‘Get Form’ button to access the questionnaire and open it in your preferred editing tool.
2. Begin with the personal history section. Fill in your full name, today's date, date of birth, age, occupation, home address, city, state, zip code, and phone numbers.
3. Next, identify your emergency contact by providing their name and phone number.
4. Indicate how you were referred to the service, which helps us understand your journey to seeking treatment.
5. Select your skin type by circling the number that best describes your skin's reaction to sun exposure.
6. Answer whether you use tanning salons or sunbathe regularly, and provide the frequency of these activities.
7. Move on to the medical history section. Respond to questions regarding your current medical care, detailing any physicians or dermatologists you are seeing.
8. Indicate if you have a history of specific skin rashes or other medical conditions by checking all applicable options.
9. List any current medications, including oral medications, mood-altering drugs, and topical treatments. Be thorough in your descriptions.
10. Note if you have had prior laser hair removal or have recently used any hair removal methods.
11. Check for any recent skin changes due to tanning or self-tanning products.
12. Answer the questions related to skin responses post-trauma and any pregnancy-related inquiries for female clients.
13. Lastly, review your responses for accuracy, sign and date the form to confirm that the information provided is correct.
14. Once completed, you can save your changes, download, print, or share the filled-out questionnaire as needed.

Take the first step towards your tailored laser treatment by completing the necessary form online.