Aiyana Atelier - Private Training Request

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Hello! The purpose of this form is to gain some more insight into your experience so that we can best help you achieve your injecting goals for training/ and or shadowing. We look forward to helping you in your aesthetic career!

Name: *

Email: *

Best Contact phone: *

Instagram handle: *

What type of training do you desire?

Shadow Day

Private Training @ Aiyana

Private Training @ My Office

Group Training @ Aiyana

Group Training @ My Office

Business Consulting

Not sure yet!

Please answer all of the below, even if the answer is zero or none:

Number of years practicing in aesthetics:

No experience

1-2 years

3-5 years

5-9 years

10 or more years

How many patients to you inject in a single day?

None at this time

1-2

3-5

5-9

10 or more

How many days/week on average do you inject?

None at this time

1-2

3-5

6-7

Other:

Have you injected tox, filler, or biostimulator before. Be specific:

What type of active license (s) do you have and the state(s) are you licensed in?

Do you maintain your own active malpractice insurance?

Yes

What are your goals for the training? Be specific.

Have you attended any conferences? Have you done any other private trainings/ shadow experiences? Please detail:

What areas of the face or body would you like to focus on? Any specific techniques your interested in learning/ enhancing?

What do you feel like is your weakest aspect of your aesthetic knowledge?

What do you feel like is your strongest aspect of your aesthetic knowledge?

Anything else you think we should know about you and your goals?

Submit

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