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**Notice for International Visitors**

This is the reservation form for Personal Beauty Clinic.
Please carefully review each item before submitting your reservation request.
Thank you for your cooperation.

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这是 Personal Beauty Clinic 的预约申请表。
请仔细确认各项内容后再提交预约申请。
感谢您的配合。

Reservation Form

■ Customer Information

■ Treatment Selection

Please select your Treatment

■ Preferred Appointment Date

●First Choice （Time）
〇Second Choice （Time）

■ Medical Information

❶ Do you have any allergies?
Yes
No
❷ Are you currently pregnant or breastfeeding?
Yes
No
❸ Have you received any medical or cosmetic treatments elsewhere within the past month?
Yes
No
❹ Have you used any skin-peeling medications or skincare products?
Yes
No
❺ Do you currently have any medical conditions or infectious diseases under treatment?
Yes
No

■ Important Notes & Consent Confirmation

PLEASE READ (OPEN THIS LINK) CAREFULLY BEFORE PROCEEDING


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