Treatment Course Completion Review

You have completed your treatment course — congratulations! This review captures your results, recovery experience, and satisfaction in your own words. Your answers help your provider fine-tune any maintenance plan and improve future care.

Section 1 — About You & Your Course

Full name:

Contact phone / email:

Date of your final session:

Which treatments did your course include? (select all that apply)

Injectables (botulinum toxin / fillers)

Laser or light-based treatments

Chemical peels / facials

Microneedling / skin boosters

Other treatment (if not listed above):

Section 2 — Results: Your Self-Assessment

For each area that was treated, rate the improvement you see from 0 (no change) to 10 (dramatic improvement), and add any comments.

Optional — upload your own before-and-after photos for comparison:

Section 3 — Recovery & Side Effects

Did you experience any of the following during the course? (select all that apply)

No noticeable side effects

Redness or swelling that settled within a few days

Bruising

Breakouts, dryness, or peeling

Pigment changes (darker or lighter patches)

Something else (describe below)

Describe any side effects — what happened, how long it lasted, and how it was resolved:

Overall, how was the recovery compared to what you expected?

Easier than expected

About what I expected

Harder than expected

Section 4 — Satisfaction Ratings

Rate each aspect from 0 (very dissatisfied) to 10 (very satisfied).

Section 5 — Looking Ahead

Would you like to continue with maintenance care?

Yes — please suggest a maintenance plan

Maybe later — contact me in a few months

No — I am happy to stop here for now

Preferred date for a check-in appointment (optional):

Anything else you would like your provider to know?

Section 6 — Confirmation

The assessments above reflect my honest experience and are accurate to the best of my knowledge.

Signature — printed name:

Date:

Thank you for completing your review. Your provider will read it carefully and follow up with a personalized maintenance recommendation.