Please enable JavaScript in your browser to complete this form.Staff Member *please select your nameNone SelectedApril ManeyJenna CliffordJason MaherLynn BrownMichaela BivinsRene LaughterTina FranklinWendi HarperProduct Sold (select all products for the patient you sold this to)Alastin Daily Beauty Regimen KitsAlastin Gentle CleanserAlastin Glitter Gift BagAlastin HydraTint Pro Mineral SunscreenAlastin Regenerating Skin NectarAlastin Renewal Retinol 0.25Alastin Renewal Retinol 0.5Alastin Restorative Eye TreatmentAlastin Restorative Neck ComplexAlastin Restorative Skin ComplexAlastin Silkshield All Mineral SunscreenAlastin TransFORM Body TreatmentAlastin TriHex Transition Duo with TriHex TechnologyAlastin Ultra Calm Cleansing CreamAlastin Ultra Light MoisturizerAlastin Ultra-Nourishing MoisturizerB- Complex 30mlBackbar PCA Peel HQ Free 2ozBackbar PCA Smoothing Toner 16 fl. ozDermaplaneFactor Five Anti Aging CreamFactor Five Eyelash CreamFactor Five Lash/Brow Growth SerumFactor Five Post Treatment KitFactor Five Regenerative SerumFemale Pellet Insertion (no insurance)Gift CardLHR - BikiniLHR - BrazilianLHR - ChinLHR - Upper LipMD PeelMembershipMIC with CyanocobalaminMiscellaneousMorpheus8Morpheus8 + PrimeMorpheus8 BodyNeocutis Aftercare Post Treatment Soothing CreamPCA Peel (face)PCA Peptide Lip TherapyPhotofacial - ChestPhotofacial - Full FacePhotofacial - Partial FacePlasma Pen - Eyebrow LiftPlasma Pen - Non-Surgical Bleph (Upper & Lower Lid)Plasma Pen - Smokers Lines (Upper and Lower)PrimePRPPRP TubesPRX Single Treatment - FacePRX-T33 Facial Laxity PeelRevitalash Advanced Eyelash/Eyebrow ConditionerSH Dream SlipSH Lip MaskSH Lip Scrub (Brown Sugar)SH Lip Slip (tube)SH Luxe Gloss (Ballet)SH Luxe Gloss (Pink)SH Luxe Gloss (Ruby)Tip Replacement FeeTone ArmsWIQO Facial Smoothing Fluid 1ozWIQO Moisturizing Face CreamHold CTRL key to select multiple optionsPatient Name *FirstLastDate procedure soldMoney amount of this transaction will be pulled from PatientNow by Tech staffSubmit
