Aromatherapy Consultation

Name

Email Address

Birthday

Allergies | Medication | Supplements

Current Health (Diagnosed Conditions, Lifestyle, Stress Levels, Anxiety...)

Health History

Current Product Routine & Treatments

Previous Product Routines & Treatments

How Would You Describe Your Skin (Appearance, Texture, Response to Heat or Products)

Any Redness? Any Redness? Temporary Permanent None

Texture Texture Dry & Flaky Taut & Tight Oily Normal

Appearance Appearance Pigmentation Reddening Dull Open Pores Slack / Loss Of Tone Broken Capillaries Dark Shadows - Eyes Puffiness - Eyes

Environment (Where Do You Spend Most Of Your Time? | Tick all that apply) Environment (Where Do You Spend Most Of Your Time? | Tick all that apply) Indoors Outdoors Hot Climate Cold Climate

Aroma Preferences (what smells are you attracted to?) Aroma Preferences (what smells are you attracted to?) Fresh & Light Strong & Heavy Herbaceous Fruity Floral Woody Neutral Citrus

Number