STEP 1: Customer Details (completed by AM, PDA or PDC and emailed to
[email protected]) 3.11.16 Today’s Date: __________________________________
Amber Beatie AM or PDA Assigned: ____________________________ 100956 Customer No: __________________________________
Julie Levesque Business Name: ________________________________ 618 NW Hill St Seminar Address: ______________________________ Bend OR 97701 _____________________________________________
_____________________________________________ Ship to Address (if different from above): _____________________________________________
Seminar Dates Provided by Account (provide 3 dates and communicate $500 Cancellation Fee) 4.11.16 1st Choice______________________________________ nd 4.13.16 2 Choice _____________________________________ rd 4.18.16 3 Choice _____________________________________
9-2 Start and End Time: ______________________________ Julie Levesque Account Contact Name: __________________________
[email protected] Contact E‐Mail: _________________________________
949-751-7605 Contact Phone #: ________________________________
_____________________________________________
After Hours Phone #: ____________________________
_____________________________________________
1 Total Number of Attendees: _______________________
PCA GOALS (list prior product purchases, competitor products, products to upsell): ___________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ List first and last name of each attendee with Responsibility (i.e., LE, MD, manager); include Account Contact if attending. Please check box next to name if contact is entered in NAV. Julie Levesque ✔____________________________________________ _____________________________________________ ____________________________________________ _____________________________________________ ____________________________________________ _____________________________________________
STEP 2: Seminar Content Details (completed by AM, PDA or PDC and Educator Confirms) SELECT SEMINAR TYPE: ✔
PCA ADVANTAGE (8 hours can be done in 6 hours with limited attendees; if 6 hours we can add one more module to day) ENHANCING YOUR SERVICES (5.5 hours; select 2 or 3 modules listed below) ADVANCED PRACTICE BUILDING (4 hours)
ENHANCING YOUR SERVICES MODULES* *Each module includes ONE hands‐on treatment except Injectables, Laser, Prescriptions & Cosmeceuticals and Cosmetic Surgery. Please note Dermaplaning Certification Course includes 2 models per attendee. (A) PCA Professional Treatments: A Deep Dive (similar to PF) (2 hrs.) (B) Microdermabrasion (1 hr.) (C) Dermaplaning (45 min.) (D) Dermaplaning Certification Course (2 hrs. theory + 3 hrs. hands‐on; 2 models per attendee, acct must have blades) (E) Microneedling (1 hr. treatment; not to exceed .25 mm) (F) Injectables (45 min.) (G) Laser including IPL (1 hr.) (H) Microcurrent (30 min.) (I) LED (45 min.) (J) Ultrasound (45 min.) (K) Radio Frequency (45 min.) In‐Office Seminar Needs Assessment Form v. 11.23.15 Continued on next page
✔
✔
(L) Advanced Applications (similar to MAA) (2 hrs.) (M) Medium Depth and Deep Chemical Peels (1 hr.) (N) Prescriptions & Cosmeceuticals (45 min.) (O) Cosmetic Surgery (45 min.) (P) Body Treatments (30 min.) (Q) Facials (30 min.) (R) Waxing (30 min.) (S) Extractions (30 min.) (T) Ingredient & Product Knowledge (3 hrs.) (U) Additional Hands‐on (if customer is requesting more hands‐on, this should be selected is its own module (est. 45 min. per treatment) NOTES: ________________________________________ _____________________________________________
pcaskin.com | 877.PCA.SKIN [722.7546]
STEP 3: Seminar On‐Site Details (Educator will confirm) DEMO / TREATMENT: Communicate importance of hands‐on experience. It is best that attendees perform and experience the treatment to get the most out of the training. EYS DEMO / TREATMENT TIMES (45 min. each): Each module includes time for ONE hands‐on demonstration. Except for Dermaplaning Certification Module, which includes 2 models per attendee. Confirm who you are performing treatments on, complete patient profile forms and the best time to conduct treatments. Timing could be after each module or combining all treatments at the end of the day. If the account would like more hands‐on, select that as a module. Encourage attendees and other staff members to be models. _______________________________________________________________________________________________ _______________________________________________________________________________________________ ADV DEMO / TREATMENT TIMES (45 min. each): ADV includes 3 treatments to begin at the end of the day unless otherwise specified. _______________________________________________________________________________________________ _______________________________________________________________________________________________ CONFIRM NUMBER OF ATTENDEES: After confirming attendees listed under STEP 1, ask if this will be the maximum number of attendees. If they state there could be more, we need to know what the number will be. This is to ensure that we send enough materials to accommodate all attendees. This is critical to a successful classroom experience. _______________________________________________________________________________________________ _______________________________________________________________________________________________ REQUESTED MATERIALS: After discussing content and maximum number of attendees, do we need additional textbooks, brochures, etc. to be included in the order? If not, please state N/A: _______________________________________________________________________________________________ _______________________________________________________________________________________________ CUSTOMER EXPECTATIONS: Ask them what success looks like at the end of this training for their business and team. _______________________________________________________________________________________________ _______________________________________________________________________________________________ Once the educator completes after discussing the educational needs with the account, the form should be emailed to the In‐Office Admin Team at
[email protected] and the assigned Account Manager or Practice Development Advisor (PDA). Materials will arrive at the account’s location 3 business days prior to the seminar. If the educator does not communicate changes, we will ship materials for the original in‐office seminar and modules selected.
In‐Office Seminar Needs Assessment Form v. 11.23.15
pcaskin.com | 877.PCA.SKIN [722.7546]
