輕醫(yī)美顧客評估表\nAesthetic Client Assessment Form

1. 姓名 Name:
2. 性別Gender:：
3. 年齡 Age:
4. 聯(lián)系電話 Contact:
5. 日期 Date:
6. 是否懷孕或哺乳中? Are you pregnant or breastfeeding?
7. 近一個(gè)月是否進(jìn)行任何醫(yī)美或雷射療程 ?Any aesthetic/laser treatment in the past month?
8. 是否對藥物或海鮮過敏? Any medication or seafood allergy?
9. 是否有皮膚疾病、疤痕體質(zhì)或其他健康問題? Any skin condition or medical concern?是否有皮膚疾病、疤痕體質(zhì)或其他健康問題 Any skin condition or medical concern?
10.

是否抽煙或飲酒等生活習(xí)慣?Do you smoke or consume alcohol regularly?


11. 是否有熬夜的習(xí)慣?Do you have a habit of staying up late?
12. 膚質(zhì)狀況 | Skin Condition
13. 護(hù)理 / 療程建議 | Recommended Treatment

14. 建議說明 Notes:
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