Treatment Record - Simply Dawn

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Treatment Record

Treatment Record

TREATMENT DATE *

TREATMENT TYPE *

CLIENT NAME *

CLIENT NAME

First

First

Last

Last

CLIENT EMAIL *

CLIENT PHONE *

KNOWN CONTRAINDICATIONS *

CHANGES TO MEDICATIONS *

Details

FACIAL

DEVICES/MODALITIES

PRODUCTS USED

CLINICAL PEEL

DEVICES/MODALITIES

PREP SOLUTION

PEEL TYPE

NUMBER OF PASSES / TIME ON SKIN

ENHANCERS

FINISHING PRODUCTS

MICRONEEDLING

NUMBING CREAM

Prescription BLT

Numbmaster

None

FOREHEAD

EYE AREA / TEMPLES

NOSE

UPPER CHEEKS

LOWER CHEEKS

UPPER LIP

CHIN

UNDER JAW

NECK

DÉCOLLETÉ

LASH & BROW

TREATMENT TYPE

Lash Lift

Brow Lamination

Lash Lift / Brow Lam Combo

Brow Wax

Lip Wax

Chin Wax

Cheek Wax

Nose Wax

Full Face Wax

Lash Tint

Brow Tint

Lash/Brow Tint

Brow Wax + Brow Tint

Brow Wax + Lash/Brow Tint

Brow/Lip/Chin Wax Trio

PRODUCTS USED

ADDITIONAL TREATMENT NOTES

PROVIDER SIGNATURE *

Date

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