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Pink Showcase

Client Pre-Screen Form

Please fill out this information to the best of your ability.  Don't hesitate to ask us to clarify anything if you are unclear. Be as honest as you can because we need accurate information to make sure we can provide you with the best service tailored to your body & health.

Health & Medical Pre-Screen

This form is confidential and judgement-free

Are you pregnant or nursing?
Do you have any current medical condition, illness, or injury?
Do you have any allergies?
Do you experience any skin conditions?
Have you ever been tattooed before?
Have you ever been prescribed Accutane?
Have you had botox within the past 2 weeks?
What is your skin type?
Do you smoke tobacco?
Have you experienced any symptoms of COVID-19 or illness in the past 14 days? (coughing, sneezing, wheezing, congestion, fatigue, headache, nausea)
Have you traveled outside of the USA or had close contact with anyone that has traveled outside of the USA in the past 14 days?
Have you had close contact with anyone with respiratory illness or a confirmed or probable case of COVID-19?
Would you prefer that our staff remains masked at all times? 

For everyone's health and safety,

  • Our staff is vaccinated and boostered.

  • If you want a fresh mask we can provide you with one.

  • Hand sanitizer is also made available in each room for your convenience.

Thanks for submitting!

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