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Facial Laser Form

About Your Skin
Please check one of the following skin tones and reactions:
Does your skin heal leaving brown marks behind?(Required)
Sun exposure/tan in the treatment area:(Required)
Please check all that apply:
If treating your face, have you had Botox or Filler in the last 2-4 weeks?(Required)
Have you had any laser treatments in the past?(Required)
What is your main concern?(Required)
Are you taking any medications?(Required)
Are you taking photo-sensitising drugs?(Required)
Are you taking Roaccutane?(Required)
Are you allergic to anything?(Required)
Are you pregnant or trying to conceive?(Required)
Do you have any of the following?(Required)
Do you suffer from cold sores?(Required)