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General Skincare Treatment Client Information & Consent Form Mobile App

The General Skincare Treatment Client Information and Consent Form mobile app is used to provide information on skincare treatments and to capture informed consent for treatment. Easily accessible from any smartphone or tablet, the app tracks details about the patient's health care history, skin care routine, current patient conditions, concerns about skin diseases and more.

The skin care app can also be customized to include your terms and conditions for payment and your own clinic's patient consent to treatment form. Once completed, the results are saved electronically for your records.

If you like this app, we would recommend checking out the client information app as well!

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Take a peek inside the General Skincare Treatment Client Information & Consent Form Mobile App

Included Features

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Included Fields

Customize to add, remove, or edit any of the fields below.

Name
Address
City
State
Zip
Phone
E-Mail
How did you hear about us?
Employer
Occupation
What would you like to achieve from your skin treatment today?
Have you ever had a facial treatment or chemical peel before?
Which of the following most closely describes your skin type?
Do you have any special skin problems or concerns?
Do you use Retin-A, Renova, or Retinol/vitamin A derivative products?
Have you used any alpha-hydroxy acid or glycolic acid products in the last 48 hours?
Are you currently taking Accutane or have you taken it in the past?
How long ago?
Have you used other acne medication?
If yes, which one?
Are you exposed to the sun on a daily basis or do you use a tanning bed?
What skin care products are you currently using?
Cleanser
Mask
Eye Product
Exfoliation / Scrubs
Treatment / Acne product
Toner
...and More!