Aesthetic Self-Assessment | Macro Med Spa

Select a body area (required)

What are your main concerns?

Select all that apply for each area. You can choose multiple options.

Face concerns

Select all that apply.

Fine lines or wrinkles Forehead, around the eyes or mouth Under-eye bags or dark circles Hollows, puffiness or heavy lids Uneven skin tone or texture Rough, dull or uneven skin Acne or enlarged pores Breakouts, marks or visible pores Sagging skin or loss of contour Softer jawline, cheeks or jowls Pigmentation or sun damage Dark spots, melasma or redness Double chin or fullness Fullness under the chin Volume loss in cheeks or lips Other concerns

Please specify

Neck concerns

Select all that apply.

Neck lines (“tech neck”) Loose or crepey neck skin Fullness under the chin Sun damage or spots Other concerns

Please specify

Chest & décolleté concerns

Select all that apply.

Crepey or loose skin Sun damage or spots Chest lines or wrinkles Other concerns

Please specify

Arm concerns

Select all that apply.

Loose skin (“bat wings”) Stubborn fat Lack of muscle tone Other concerns

Please specify

Abdomen concerns

Select all that apply.

Stubborn fat Loose or crepey skin Weak core or muscle tone Post-pregnancy changes Stretch marks Surgical or C-section scars Other concerns

Please specify

Waist & flank concerns

Select all that apply.

Love handles / flank fat Hip & waist shape Other concerns

Please specify

Back concerns

Select all that apply.

Bra-line bulges Back fat Back breakouts or texture Other concerns

Please specify

Buttock concerns

Select all that apply.

Lack of lift or shape Cellulite Loose skin Other concerns

Please specify

Thigh concerns

Select all that apply.

Outer thighs (“saddlebags”) Inner thighs Cellulite Loose skin Other concerns

Please specify

Knee concerns

Select all that apply.

Loose skin above the knee Fullness around the knee Other concerns

Please specify

Calf & lower-leg concerns

Select all that apply.

Calf / lower-leg contour Muscle tone Other concerns

Please specify

Full-body concerns

Select all that apply.

Overall fat reduction Loose skin after weight loss Overall muscle tone Puffiness or fluid retention Other concerns

Please specify

What are your goals?

Select all that apply for each area. You can choose multiple options.

Neck goals

Select all that apply.

Smoother neck, softer lines Tighter, firmer neck skin Reduce fat under the chin Even tone, fewer spots Prepare for an event Wedding, vacation or photoshoot Other goal

Please specify

Chest goals

Select all that apply.

Firmer, smoother décolleté Even tone, fewer sun spots Softer chest lines Prepare for an event Wedding, vacation or photoshoot Other goal

Please specify

Arm goals

Select all that apply.

Tighter skin on the upper arms Slimmer upper arms Toned, defined arms Prepare for an event Wedding, vacation or photoshoot Other goal

Please specify

Abdomen goals

Select all that apply.

Reduce stubborn belly fat Tighter, firmer skin A stronger, toned core Smoother scars or stretch marks Prepare for an event Wedding, vacation or photoshoot Other goal

Please specify

Waist goals

Select all that apply.

Reduce love handles A more sculpted waistline Prepare for an event Wedding, vacation or photoshoot Other goal

Please specify

Back goals

Select all that apply.

A smoother bra-line area Reduce back fat Clearer, smoother back skin Prepare for an event Wedding, vacation or photoshoot Other goal

Please specify

Buttock goals

Select all that apply.

A lifted, fuller shape Smoother, less dimpled skin Firmer, tighter skin Prepare for an event Wedding, vacation or photoshoot Other goal

Please specify

Thigh goals

Select all that apply.

Slimmer, more sculpted thighs Smoother, less dimpled skin Tighter thigh skin Prepare for an event Wedding, vacation or photoshoot Other goal

Please specify

Knee goals

Select all that apply.

Tighter skin above the knee A slimmer knee contour Prepare for an event Wedding, vacation or photoshoot Other goal

Please specify

Calf goals

Select all that apply.

Better-shaped calves Firmer, toned calves Prepare for an event Wedding, vacation or photoshoot Other goal

Please specify

Full-body goals

Select all that apply.

Overall fat reduction All-around waist contouring Full-body skin tightening Post-weight-loss rejuvenation Muscle toning (EMS-type treatments) Less puffiness (lymphatic drainage) Prepare for an event Wedding, vacation or photoshoot Other goal

Please specify

When is your event?

Within a month In 1–3 months In 3–6 months 6+ months away

Optional — helps the team recommend services accurately.

How would you describe your daily activity level?

Low (sedentary) Moderate Active

Do any of these apply to you?

Select all that apply.

Recent weight fluctuations Hormonal changes Sensitive skin History of aesthetic treatments None of these apply

Tell us where to send your results

Get personalized recommendations from our team.

First name

Last name (optional)

Email

Phone (optional)

Preferred contact method

Email Call Text

Would you like a complimentary consultation?

Yes Not yet

Optional: upload photos (front, side, back)

Photos help your provider prepare. They are stored privately and only visible to clinic staff.

Front Add photo

Side Add photo

Back Add photo

Photos are stored privately and are only visible to clinic staff. JPG, PNG, WEBP or HEIC.

Advanced Self-Assessment

Select a body area (required)

What are your main concerns?

Face concerns

Neck concerns

Chest & décolleté concerns

Arm concerns

Abdomen concerns

Waist & flank concerns

Back concerns

Buttock concerns

Thigh concerns

Knee concerns

Calf & lower-leg concerns

Full-body concerns

What are your goals?

Face goals

Neck goals

Chest goals

Arm goals

Abdomen goals

Waist goals

Back goals

Buttock goals

Thigh goals

Knee goals

Calf goals

Full-body goals

When is your event?

How would you describe your daily activity level?

Do any of these apply to you?

Tell us where to send your results

Preferred contact method

Would you like a complimentary consultation?

Optional: upload photos (front, side, back)

Select a body area* (required)

What are your main concerns?

Face concerns

Neck concerns

Chest & décolleté concerns

Arm concerns

Abdomen concerns

Waist & flank concerns

Back concerns

Buttock concerns

Thigh concerns

Knee concerns

Calf & lower-leg concerns

Full-body concerns

What are your goals?

Face goals

Neck goals

Chest goals

Arm goals

Abdomen goals

Waist goals

Back goals

Buttock goals

Thigh goals

Knee goals

Calf goals

Full-body goals

When is your event?

How would you describe your daily activity level?

Do any of these apply to you?

Tell us where to send your results

Preferred contact method

Would you like a complimentary consultation?

Optional: upload photos (front, side, back)

Stay in the loop!

You're all set!

Select a body area (required)