Clone of Lip Blush/Neutralizer Candidate Quiz

IS LIP BLUSH/LIP NEUTRAZILER SUITABLE FOR YOU?

Let's find out...
First Name*
Email*
example@example.com
What is your age?
*By entering your details you give permission for me to contact you in the future with updates of my work and any offers.
Have you previously had any form of LIP BLUSH tattooing?*

YesNo
Do you smoke?*

YesNo
Are you currently pregnant or breast feeding?

YesNo
Have you had lip filler, or Botox in the last 2 months?

YesNo
Do you have any of the following on your lips?*

WrinklesCold Sores or History of a cold soreDry LipsScarsLip FillersNoneHyperpigmentation
Have you ever used or currently using any of the following?*

Retin A (a medication used to treat acne)Accutane (a medication used to treat acne)Glycolic Acid (can often be found in face creams)None of the above
Are you taking medications that may affect how your skin responds to blood clotting and healing?*

YesNo
If so, what is your medication and what are you taking it for?
Are you currently going through chemotherapy ?*

YesNo
Do you fill in your lips most days with makeup?

NeverSometimesEveryday
Is the skin on your face by the lip area affected by rosacea, eczema, or dermatitis (very red or dry, flaking or irritated skin)?

YesNo
Have you ever had a reaction to any type of tattoo ink?

YesNo
Do you have an autoimmune condition like Lupus or Uncontrolled Diabetes or Uncontrolled High Blood Pressure?

YesNo
Have you used Accutane in the last year, or Retinol A?

YesNoUnsure
Share a "Lip selfie" with no photo filters, in good lighting, and our artists will send you a custom profile with what we recommend for your lips.*

Cancelof
Share a photo of your goal lip result. (optional)

Cancelof
How did you hear about us*
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IS LIP BLUSH/LIP NEUTRAZILER SUITABLE FOR YOU?