Mary Williams -Lowe –

Full Name: Mary Williams -Lowe
Date of Birth: 1960-09-15
Email Address:
Emergency Contact: 6493456577
Medical History : Low-High BP, –
Additional Details : High blood pressure
Have you been under the care of a dermatologist within the past year? No, –
Are you taking any medications or dietary supplements? Yes, –
Have you had any surgery in the last 12 months? No, –
Have you received Botox, Restylane, Collagen or any other injections in the last 6 months? No, –
Do you wear contact lenses? No, –
Is there anything that may be important for us to know? High blood pressure
For ladies: Are you pregnant, planning a pregnancy, breastfeeding, using birth control or menstruating? Array
For ladies: Are you taking birth control pills? No,
Body Concerns:Poor Circulation, –
What is your current facial care routine? No

Facial concerns: Other (please specify), – No
What is your current body care routine?

Name : Mary Williams-Lowe
Signature :

Enter Date : 2022-05-05

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