CLIENT ANSWER QUESTIONS 1-5
1. Have you had any cosmetic surgeries, laser resurfacing, chemical peels, or dermabrasion?
If yes, when?
2. Have you had any recent injectables, fillers, or botox?
3. Do you use Retin-A, other vitamin A products, or other medications that exfoliate or thin the skin?
4. Are you currently on any photosensitizing medications?
STUDENT FILL OUT THE PORTION BELOW
Skin Type and Aging:
___ Fitzpatrick I
___ Fitzpatrick II
___ Fitzpatrick III
___ Fitzpatrick IV
___ Rubin I
___ Rubin II
___ Rubin III
Improved since last treatment? __Yes __No
___ Rough Texture or Solar Damage
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Document Name: Microdermabrasion Assessment
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