Skincare Evaluation

Skincare Evaluation

Help us create the best skincare regime for you! With your input, we'll be able to choose the best products for you that will give you the exact results you're after.
Name*

First NameLast Name
Email Address *
example@example.com
Phone Number (Optional)
Please enter a valid phone number.
1. What is your age range?

20's30's40's50's+
2. What type of skin do you have?

NormalDryOilyCombination(oily & dry)SensitiveOther
3. What is your biggest concern about your skin?

Hyperpigmentation/Sun DamageRosacea/RednessDryness/irritationLarge PoresMelasmaFine lines and wrinklesAcne/acne scarring
4. How much makeup do you use per day?

NoneA littleA decent amountFull coverage
5. How often do you feel that your skin is sensitive?

NeverRarelySometimesAlways
6. Do you feel stressed about how you look and feel?

YesNo
7. Do you experience any of the following medical conditions? (Check all that apply)

Digestive issuesPregnant or NursingAutoimmune DiseaseCancerProlonged StressThyroid diseaseHormonal imbalancesAdrenal dysfunction
8. What type of weather do you experience where you live?

Sunny & TropicalDry and hotCold winter and warm summerCold and dry year round
9. How much time do you spend to take care of your skin per day?

Less than 5 minutes;6 to 15 minutesMore than 15 minutes
10. How do you wash your face?

Just waterWater and a foaming cleanserWater and an oil based cleanserCleaning with facial wipesGel based cleanserOther
11. How often do you workout?

Never1-2 times a week3-5 times a week6-7 times a week2x times a day
12. How often do you feel stressed?

NeverSometimes, maybe 1-2 times a weekOften, more then 2 times a weekEvery day
13. How much sun exposure do you get?

Less than 1 hour per day2-4 hours per dayMore than 4 hours per day
14. What kind of SPF do you use? (Check all that apply)

TintedNon-tintedMineral basedWater resistant/ sweat resistant
15. Do you have any allergies?

YesNo
Please include a photo of your skin.

Follow the steps bellow to take a proper photo.
Click on a button bellow to take a photo
The personal details you just provided will stay confidential and we will not pass it on to third parties.

You will be redirected to Zenoti, our booking platform, to schedule your consultation at time that best suits you.
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Skincare Evaluation

Please include a photo of your skin.