Laevo Assessment

1

Name* This field is required.

First Name

Last Name

2

Email* This field is required.

example@example.com

3

How would you describe your skin right now?* This field is required.

I want to maintain and prevent

I want to correct and stabilize

4

Compared to a few years ago, your skin now feels:* This field is required.

More stable

Slightly more sensitive

More reactive

Harder to manage

Same

5

How quickly does your skin recover after irritation or breakouts?* This field is required.

Very fast

Few days

Over a week

Leaves marks

Not sure

6

When your skin gets a mark (acne, irritation), it:* This field is required.

Fades quickly

Lingers for weeks

Turns into dark spots

Keeps coming back

Not sure

7

Does your skin tolerate products the same way it used to?* This field is required.

Yes

Slightly less

No, I react more easily now

Not sure

8

Do you experience:* This field is required.Select all that apply.

Tightness after washing

Burning with products

Flaking / dryness

None

9

Your breakouts are:* This field is required.

Rare

Occasional

Hormonal (jawline / monthly)

Frequent / persistent

10

Type of acne:* This field is required.Select all that apply.

Whiteheads / blackheads

Red inflamed pimples

Deep painful cysts

None

11

After breakouts, your skin:* This field is required.

Clears fully

Leaves marks

Leaves dark spots

Leaves both marks and texture

12

Have you noticed any of the following?* This field is required.Select all that apply.

Skin feels thinner

Skin looks dull more often

Texture feels uneven

Fine lines appearing

None

13

Have you used retinoids before?* This field is required.

Never

Yes, tolerated well

Yes, caused irritation

Could not tolerate

14

Which best describes you?* This field is required.

Under 30

30–40

40–50

50+

15

Are you:* This field is required.

Pregnant

Breastfeeding

Trying to conceive

None

16

Do you have:* This field is required.Select all that apply.

Eczema

Rosacea

Psoriasis

None

17

How would your skin react to sun exposure?* This field is required.

Always burns, never tans

Burns easily, tans minimally

Sometimes burns, tans gradually

Rarely burns, tans easily

Very rarely burns, deeply pigmented

18

Do you have any known allergies to medications or skincare ingredients?* This field is required.

19

List your current skincare products.* This field is required.Please be as thorough as possible.

20

What matters most to you?* This field is required.

My skin feels stable and predictable

I want fewer breakouts

I want even tone

I want overall skin improvement

21

Take a close-up photo of concern area* This field is required.

22

Consent* This field is required.

23

Terms and Conditions* This field is required.