Please provide the following information which will help us provided you with the best, personalized treatment possible. All information is kept confidential. Thank you!

As a token of our gratitude for you taking a few minutes to fill out this form, we would like to offer you 10% off of any products you wish to purchase during your first visit with VISO PURO.




1.) What is your skin type? Please check all that apply:
2.) What are your skin care concerns and/or what would you like to prevent? Please check all that apply:
4.) What is your skin care routine at home? Please check all that apply:
5.) Do you prefer a foamy, milky or oil cleanser? Please check one:
6.) Do you prefer a gentle or active exfoliant? Please check one:
7.) Do you prefer matte, medium or dewy moisturizer? Please check one:

Liability Waiver Agreement:

Nadine Strong shall not be liable for any injuries or skin reactions from services or products administered at VISO PURO. No promises or guarantees have been made regarding the results from the use of our treatments or skincare products. We are not responsible for the loss or theft of any personal property, which each person is responsible for safe guarding. It is incumbent upon you to inform us of any known allergies or medical issues (including pregnancy) at each visit. People have have health problems or on prescription medications should check with their physician before receiving a facial purchasing products. I, the customer agreeing to the aforementioned terms have been honest in disclosing all known medical issues. I understand and waive my right to prosecute should there be any reaction to my skin or body from treatments provided by VISO PURO. Parental consent is required if you are under the age of 18.

By checking this box I agree to the terms of the Liability Waiver Agreement.