(587) 772-6449 Appointment

Intake Form – Body Sculpting Xthetics Face & Body Sculpt

Name (Required)

Have you had any bariatric surgeries such as a "Lap-band","sleeve",etc?

Do you have any active implanted devices such as pacemakers and defibrillators?

Do you have any wounds (open or healing), surgeries, or Scarring within the last 12 months in the treatment region?

Do you have a history of neuropathic disorders such as diabetic neuropathy or post-herpetic neuralgia?

Do you have a history of poor blood flow or impaired sensation in the area to be treated?

Have you had surgery previously (especially discuss surgeries in treatment regions)?

Have you had non-surgical cosmetic treatment in the area to be treated?


Schedule Your Consultation Today

Each person that walks into our office has unique needs, desires, and concerns. We know the only way to provide you with a personalized treatment plan is to listen. During your initial consultation, we take the time to clarify and understand your goals and educate you as to the treatment options available. Xthetics Face & Body Sculpt offers advanced, medical-grade aesthetics solutions from compassionate, patient-focused professionals. Schedule a consultation today.

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425 11th Avenue SE, Calgary, AB T2G 0Y4, Canada