top of page

CEMO LASER CLINIC SKIN ASSESSMENT FORM

Skin Assessment

What is your primary skin concern? (Select all that apply)
What is your skin type?
Have you had professional skin treatments before?
Yes, Regularly
Yes, But only once or twice
No, This is my first time
How would you describe your current skincare routine?
Minimal (cleanser & moisturizer)
Basic (cleanser, moisturizer, SPF)
Advanced (includes serums, exfoliation, masks)
Professional (prescribed treatments & in-clinic procedures)
What result are you hoping to achieve from your treatment?

Treatment Action

How soon are you looking to start your skin treatment?
Do you have any of the following conditions? (Select all that apply)
Have you used any prescription skincare (e.g., Retinol, Accutane) in the past 6 months?
Yes, currently using
Yes, but I stopped recently
No

Thank you for completing your skin assessment! Our skincare experts will review your responses and recommend a personalized treatment plan. Book your exclusive consultation now to take the next step toward your best skin!

© 2023 by Cemo Laser Clinic

bottom of page