Welcome to Creature of Habit!

1. Name (required) *
2. Phone No. *
3. Email Address (required) *
4. Date of Birth *
5. Postal Code
6. How did you find us? InstagramSocial Media (FB / TT_FriendsSearch Engine (Google)
7. Have you ever had a facial done? YesNo
8. What's your skin type? NormalDryCombinationOilySensitiveDehydratedRednessAcne/Acne ProneEnlarged PoresEczemaPitted ScarsAcne Scars
9. Are you an existing customer? YesNo
10. Have you ever had a chemical peel, laser or micro-dermabrasion? YesNo
11. Are you using any acids? YesNo
12. Are you allergic to any medication or cosmetic ingredients? YesNo
13. If yes, please indicate:
14. If unsure, do you still wish to proceed? * YesOther
15. Are you on any oral or topical medication? YesNo
16. Have you done any facial hair removal? YesNo
17. Do you have any facial scarring? YesNo
18. If yes, please indicate:
19. Any areas you wish to avoid? YesNo
20. If yes, please indicate:
21. What would you like to achieve for your skin? Please state: * Reduce Acne ScarsReduce Enlarged PoresBrighter Skin & Hydrated SkinLighten DarkspotsSlimmer Jawline
22. I understand that mild breakouts or purging may occur after a Bo Jin treatment as part of the skin’s natural detoxification process. This reaction is temporary and considered a normal response as the skin eliminates impurities and adjusts to the treatment. * I acknowledge and consentI do not consent

23. Please sign here & click "SUBMIT"

24. *
All treatments will be discussed and agreed verbally before we proceed. Any possible side effects, if any will also be made known to you. By signing this form, you agree to the treatments recommended by our therapists and the terms & conditions of the company.

* Required