Full Name: Matthew Bernarducci
Date of Birth: 1988-11-16
Email Address: mbernarducci@gmail.com
Emergency Contact: Samantha Wagner
Medical History : Asthma, –
Additional Details : NA
Have you been under the care of a dermatologist within the past year? No, –
Are you taking any medications or dietary supplements? No, –
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?
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:Aches / Pains, –
What is your current facial care routine? Sunscreen moisturizer in the morning and moisturizer at night
Facial concerns: Aging, Breakouts / Acne, –
What is your current body care routine?
Name : Matthew Bernarducci
Signature : https://www.mrvlspa.com/wp-content/uploads/ocswcf_signatures/signature-704-1652280689.png
Enter Date : 2022-05-11
