DREAMLAB

CUSTOM PROJECT

Confidential Client Intake Form

hey babe,

We are so excited to be able to work with you on a custom skin project. DREAMLAB was built with the desire to help transform our clients skin from HEAD TO TOE. To truly have the best skin in the room requires a treatment program made just for you! Did you know that no two people are like? To transform your skin requires an understanding of your skin, your skin goals, and using the right treatments, with the right level of actives, at the right time to deliver those outcomes. We cannot wait to get started. Please fill out this form so we can begin your custom project.

Name

First Name

Last Name

Email Address

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

What's Your Age?

Have You Been Under The Care of A Dermatologist In The Past Year?

Describe Your Skin: Dry, Oily, Normal, Combination

What Concern's Do You Have About Your Skin?

What Are Your Top Three Skin Care Goals?

Are You Presently Using Retin-A?

In The Last 3 Months Have You Received An In-Office Peel, MicroNeedling or RF Treatment?

Anything Else We Should Know About Your Skin?

Cancellations.

We require a 50% deposit upfront to begin your custom project. Deposits are nonrefundable. Custom projects take approximately 7 to 10 days to complete. Once finalized, the lab will reach out to you for your payment. Please check Yes or No, If you agree to our cancellation policy.

YES

NO