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Consultation form with facial marking

Skin concerns and treatment areas are spatial. A front and side head outline lets clients show exactly what they want looked at.

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Name *

Circle or mark a spot on the outline *

Demo only — nothing here is sent.

Client circles areas of concern on the front and side views.

Add questions on skin type, allergies, and past treatments.

Review the marks before the consultation instead of during it.

The drawing field is for marking on a diagram. Photos are handled by the file upload field.

TinyForm emails submissions and is not a HIPAA-covered service. Do not collect information your obligations do not allow over email.