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You Glo Skin Consultation Intake

Thank you for choosing Skin Consultation at You Glo

This form is to gather information to help us understand your skin goals, challenges you may be facing, and how to proceed with making recommendations. Anything you are willing to share related to your skincare products, daily rituals, lifestyle, food sensitivities, fears/anxiety, etc is appreciated and welcomed

After submitting this form, you will be directed to the payment link

Once payment is received, you will receive another email with a booking link to book your 30 minute consultation. Please note: Consultations are designed for in person connection. If you are unable to physically be here for an appointment, please contact us hello@youglo.ca

Full Name

Phone Number

Email

How did you hear about You Glo?

What is your skin's story? (permission to tell us anything and everything you are comfortable sharing)

What is your current daily ritual with skincare?

(there are no judgements at You Glo)

What are your primary skin concerns?

Do you have allergies or sensitivities to anything?

Are you using any of the following? (Accutane, Retin A, Retinol, Vitamin A, Birth Control, AHA's, BHA's, Vitamin C products, Glycolic products, Lactic products or Salicylic products)

If so, please provide information about when you started using and how often you use it.

What has held you back from getting facials or seeking guidance, in the past? (if any)

Additional Notes

Please feel free to add anything else you'd like us to know prior to the consultation.