Smile Aesthetics by Jamie
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About you

So we know who we are speaking to.

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Medical questions

Tap yes or no. Most people answer no to all of these.

Are you/Could there be a chance you are pregnant?
Are you receiving any treatment from a Doctor or Healthcare Professional?
Do you carry a Medical Warning Card?
Do you have any Allergies? If yes, please detail below.
Do you have any Chest Conditions? (e.g. Asthma)
Do you suffer from any Neurological Conditions? (e.g. Epilepsy, Fainting)
Do you suffer from any Muscular Conditions? (e.g. Dystrophy, Myasthenia Gravis)
Do you have any Heart Conditions? (e.g. Angina, High Blood Pressure)
Do you have Diabetes?
Do you bruise easily?
Do you have a history of cold sores?
Do you have any Infectious Diseases? (e.g. HIV, Hepatitis, TB)
Do you have any history of keloid or hypertrophic scarring?
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Medication and lifestyle

Nearly there.

Have you ever taken medication or been prescribed topical medication for Acne? (e.g. Tretinoin, Roaccutane)
Do you smoke?
Do you drink alcohol?
Do you take any illicit substances? (e.g. Cannabis, MDMA)
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Treatments you may be interested in

No commitment, it just helps us plan your visit.

Botox
Filler (i.e. cheeks/jaw/chin/lips/facial rejuvenation)
Relaxing Facials
Advanced Facials (i.e. Microneedling/Chemical Peels)
"Full MOT" Blood Health Testing
Skin Analysis & Skincare/Treatment Recommendations

Thank you

That is saved to your record. There is nothing to print or bring with you.

If anything changes before your appointment, just tell us on the day.