Intake form

Help us serve you better

Name *

Email address *

What services are you interested in?

Please select at least one option.

Luxury facial treatments

High-tech facials

Peels

Acne treatments

Holistic services

Have you had any facial treatments before?

Do you have any specific skin concerns?

What is your skin type?

Are you currently taking any medications that affect your skin?

If yes, please specify the medication(s):

Have you experienced any allergies?

If yes, please specify the allergies:

What is your age range?

How did you hear about us?

Which service or services are you interested in?

Please select at least one option.

Luxury facial treatments

Peels for every occasion

Holistic reiki healing

Additional questions or comments

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PARI Cardoni Wellness & sanctuary