Head2Soul CACI Consultation Form
Please fill in the following answers. After we will get in contact with to let you know if you are suitable for treatment and what treatment we would recommend to you.
What is your name?
What are your contact details?
Have you ever had a Caci facial before or any other face-lifting facials?
What are your target areas of concern?
What are your treatment expectations?
Please tick the following boxes that apply to you.
Do you have a Pacemaker
Any forms of Cancer.
Retin A/ roaccutane
Skin lesions cuts/ burns
Metal implant/ IUD
Severe muscle conditions
On hormone replacement therapy
IBS or other bowel conditions.
Asthma/ breathing problems.
Add any other medical history or additional comments you would like us to see.
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