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Client Intake & Consultation

Welcome to Lokenani! I’m excited to guide you on your skincare journey. As I operate solo, I personally ensure every treatment is customized to your unique needs. To help me provide the best care, I ask all new clients to fill out a brief intake form before their first appointment. This will give me the insights I need to tailor your treatment to your skin's needs and goals. Please take a few moments to complete it, and I look forward to meeting you soon for your personalized skincare consultation!

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Please Complete

Client Intake

General Information

Medical History & Limitations

Are you currently taking any medications?
Yes
No
Do you have any allergies?
Yes
No
Do you have any medical or physical limitations we should be aware of to ensure your comfort and safety during the service? (e.g., surgeries, chronic conditions, etc.)
Yes
No
Have you ever been treated for cancer?
Yes
No
Do you have any of the following? (Check all that apply):

Service History

Have you experienced any issues or discomfort with previous service providers that you’d like to share with us to ensure a better experience?
Yes
No

Skin Care History

What skin type do you think you have? (Check one):
Check any concerns you have:
Have you used any of the following in the past 72 hours?
Have you recently:

Skin Care Products

What products do you currently use?

Photo and Video Consent  

I give permission to Amoie / Lokenani to use photos and/or videos taken during my treatment for promotional purposes. I understand these may be used in marketing materials, including social media, and I will not receive compensation for their use.
Yes
No, I do not consent

Consent & Liability Waiver  

Cancellation Policy

Are you scheduled for a Chemical Peel
Yes
No

If yes, complete Chemical Peel Consent form under "Book Online' tab.

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