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The form collects student identity details and exam date, and includes examiner witness certification under MN Statute 155A.33, Subd. 4-6. It provides checklist sections for advanced exfoliation (chemical peel, machine/device options), advanced skin care techniques, and skin needling, with pass/fail status plus automatic fail incident categories and required important instructions.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":20,"@type":76,"position":81},"https://docshare.wps.com/document/exam/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/advanced-practice-esthetics-practical-skills-test-results-form-2019-signature/312817/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/advanced-practice-esthetics-practical-skills-test-results-form-2019-signature/312817.png","ImageObject",300,407,{"name":92,"@type":93},"Bintang","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-05","2026-09-20",true,{"@type":102,"interactionType":103,"userInteractionCount":19},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What does the student certification section require?","Question",{"text":112,"@type":113},"The student certifies, under penalty of MN Statute 155A.33, Subd. 4-6, that the scores shown on the form are true and accurate, and provides printed name, signature, and date.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How does the examiner certification work on the form?",{"text":117,"@type":113},"The examiner certifies under penalty of MN Statute 155A.33, Subd. 4-6, that they witnessed the examinee take the Practical Skills Test and obtain the scores reflected on the form, including printed name, school details, exam date, and examiner title.",{"name":119,"@type":110,"acceptedAnswer":120},"Which events are listed as automatic fail incidents?",{"text":121,"@type":113},"Automatic fail incidents include an injured client or self; failure to detect allergy/contraindication; contaminated unused product; failure to wash hands or use gloves appropriately; use of prohibited/unclean items; improper use of machine/device/tool/product; failure to complete the service; cheating; and violations of Minnesota Statute 155A or Rule Chapters 2105 or 2110.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},312817,1791300204,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":19,"category_name":20,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":19,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":8,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":81,"preview_page_count":4},962085564381,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","1000 University Avenue W, Suite 100 | St. Paul, MN 55104 [cosmetology@state.mn.us | mn.gov/boards-cosmetology](cosmetology@state.mn.us | mn.gov/boards-cosmetology)  \nAdvanced Practice Esthetics Practical Skills Test Results Form  \nStudent Name:    \nBirth Date:    \nResults Certification by Student  \nI certify, under penalty of MN Statute 155A.33, Subd. 4-6, that the scores reflected on this Practical Skills Test Results Form are true and accurate.  \nPrinted Name:    \nSignature:   Date:  \nResults Certification by Examiner  \nI certify, under penalty of MN Statute 155A.33, Subd. 4-6, that I have witnessed the examinee listed above take the Practical Skills Test and obtain the scores reflected on this form.  \nPrinted Name:  \nSchool Name:  \nSchool Location:  \nExam Date:  \nExaminer Name:  \nExaminer Title:  \n\n|  |\n| --- |\n|  |\n|  |\n|  |\n\n\n| Advanced Exfoliation: Chemical Peel |  |  |\n| --- | --- | --- |\n| Pre-Service |  |  |\n| 1. Client consultation | Y | N |\n| 2. Skin analysis | Y | N |\n| 3. Consent form | Y | N |\n| Set Up |  |  |\n| 1. Wash hands | Y | N |\n| 2. Prepare work area | Y | N |\n| 3. Drape model | Y | N |\n| Service |  |  |\n| 1. Wear gloves | Y | N |\n| 2. Prepare model’s face | Y | N |\n| 3. Apply peel | Y | N |\n| 4. Monitor peel | Y | N |\n| 5. Neutralize peel, if applicable | Y | N |\n| 6. Apply finishing product, if applicable | Y | N |\n| Completion |  |  |\n| 1. After care directions | Y | N |\n| 2. Clean and disinfect | Y | N |\n| Circle one: Passed Section Failed Section |  |  |\n| If failed, list reason: |  |  |\n\n\n| Advanced Skin Care Techniques |  |  |\n| --- | --- | --- |\n| Pre-Service |  |  |\n| 1. Client consultation | Y | N |\n| 2. Skin analysis | Y | N |\n| 3. Consent form | Y | N |\n| Set Up |  |  |\n| 1. Wash hands | Y | N |\n| 2. Prepare work area | Y | N |\n| 3. Drape model | Y | N |\n| Service |  |  |\n| 1. Prepare model’s face | Y | N |\n| 2. Lymphatic drainage massage and electrical energy treatment | Y | N |\n| 3. Application and removal of mask | Y | N |\n| 4. Apply finishing product | Y | N |\n| Completion |  |  |\n| 1. After care directions | Y | N |\n| 2. Clean and disinfect | Y | N |\n| Circle one: Passed Section Failed Section |  |  |\n| If failed, list reason: |  |  |\n\n\n| Advanced Exfoliation: Machine or Device |  |  |\n| --- | --- | --- |\n| Pre-Service |  |  |\n| 1. Client consultation | Y | N |\n| 2. Skin analysis | Y | N |\n| 3. Consent form | Y | N |\n| Set Up |  |  |\n| 1. Wash hands | Y | N |\n| 2. Prepare work area | Y | N |\n| 3. Drape model | Y | N |\n| Service |  |  |\n| 1. Wear gloves | Y | N |\n| 2. Prepare model’s face | Y | N |\n| 3A. Dermaplane procedure | Y | N |\n| 3B. Crystal microdermabrasion procedure | Y | N |\n| 3C. Diamond microdermabrasion procedure | Y | N |\n| 3D. Hydradermabrasion | Y | N |\n| 4. Apply finishing product | Y | N |\n| Completion |  |  |\n| 1. After care directions | Y | N |\n| 2. Clean and disinfect | Y | N |\n| Circle one: Passed Section Failed Section |  |  |\n| If failed, list reason: |  |  |\n\n\n| Automatic Fail Incidents |  |\n| --- | --- |\n| A. Injured client or self | F. Used prohibited or unclean item |\n| B. Failed to detect allergy or contraindication that would cause significant harm | G. Improperly used machine, device, tool, or product |\n| C. Contaminated unused product | H. Failed to complete service |\n| D. Did not wash hands prior to service | I. Cheated |\n| E. Did not where gloves when appropriate; Did not wash hands or replace gloves when contaminated | J. Violated Minnesota Statute 155A or Rule Chapters 2105 or 2110 |\n\n\n| Important Details |  |\n| --- | --- |\n| • A separate Results Form must be used for each test day. Any section that is not tested must be crossed off of the form.\u003Cbr>• The examiner must circle whether the student passed or failed and note any Automatic Fail Incidents that occurred.\u003Cbr>• Each Results Form must show accurate information and be signed. |  |\n\n| Skin Needling |  |  |\n| --- | --- | --- |\n| Pre-Service |  |  |\n| 1. Client consultation | Y | N |\n| 2. Skin analysi","cbCaipv90iDPCY1L","https://ap.wps.com/l/cbCaipv90iDPCY1L","pdf",234107,"English","# Student Information & Certifications\n## Results Certification by Student\n## Results Certification by Examiner\n# Practical Skills Checklists\n## Advanced Exfoliation: Chemical Peel\n## Advanced Skin Care Techniques\n## Advanced Exfoliation: Machine or Device\n## Skin Needling\n# Automatic Fail Incidents & Important Details\n## Automatic Fail Incidents\n## Important Details","[{\"question\":\"What does the student certification section require?\",\"answer\":\"The student certifies, under penalty of MN Statute 155A.33, Subd. 4-6, that the scores shown on the form are true and accurate, and provides printed name, signature, and date.\"},{\"question\":\"How does the examiner certification work on the form?\",\"answer\":\"The examiner certifies under penalty of MN Statute 155A.33, Subd. 4-6, that they witnessed the examinee take the Practical Skills Test and obtain the scores reflected on the form, including printed name, school details, exam date, and examiner title.\"},{\"question\":\"Which events are listed as automatic fail incidents?\",\"answer\":\"Automatic fail incidents include an injured client or self; failure to detect allergy/contraindication; contaminated unused product; failure to wash hands or use gloves appropriately; use of prohibited/unclean items; improper use of machine/device/tool/product; failure to complete the service; cheating; and violations of Minnesota Statute 155A or Rule Chapters 2105 or 2110.\"}]","Advanced Practice Esthetics Practical Skills Test Results Form - 2019 - Signature | PDF",1789896246]