Assesment

Mind Body Connection Skincare By Natalie 632-2727 Name:______________________ Date___________________________ Address___________________________________________________ Email______________________ Would you care to be on our mailing list Y or N Who do we thank for your referral___________________________________________________? YOURE HISTORY 1. For the last category fuck off you been down the stairs a dermatologist or a strong-arm care?_______ 2. In the last month have you under gone surgery_____________? If yes please explain______________________________________________________________________________________________________________________________________________________ 3. Have you had in the past year or presently any health problems ___________? If yes please explain______________________________________________________________________________________________________________________________________________________ 4.

heel any medications, supplements, vitamins, diuretics, slimming tablets etc that you take on a regular basis_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 5. Do you smoke?_______________ 6. Do you exercise regularly?______________________ 7. Do you watch a restricted diet?_____________________________ 8. Do you wear feeling lenses?___________________ 9. Do you have a pace maker, metal implants or body peircings?____________________________ 10. Rate your level of stress on a scale of 1 world low 4 being high____________ Youre Skin 11. Do you have skin problems pertaining to your face? ______________ If yes please... If you destiny to get a full essay, order it on our website: Orderessay

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