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- CA Katie Hartman Client Intake Form - Facial 2013
Get CA Katie Hartman Client Intake Form - Facial 2013-2024
E past year? O No O Yes Have you had any of these health conditions in the past or present? (Please check all that apply and provide additional information in the space provided) 0 Cancer 0 Arthritis 0 Immune disorders 0 Hormone imbalance 0 Asthma 0 HIV/AIDS 0 Systemic disease 0 Eczema 0 Lupus 0 High blood pressure 0 Epilepsy 0 Metal bone pins or plates 0 Spinal injury 0 Seizure disorder 0 Phlebitis/blood clots 0 Thyroid condition 0 Headaches (chronic) 0 Blood clotting abnormali.
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