Skin Consultation

As part of our service we provide free skin care consultation, if you could answer the questions below we will be able to help you.

    [bscolumns class="one_half"]Name*

    [/bscolumns][bscolumns class="one_half_last"]Email address*

    [/bscolumns]

    [bscolumns class="one_third"]
    How would you diagnose your skin type?

    [/bscolumns][bscolumns class="one_third"]
    What are your concerns with your skin?

    [/bscolumns][bscolumns class="one_third_last"]
    What products are you currently using?

    [/bscolumns]

    [bscolumns class="one_half"]Do you have a regular skin care routine at home morning and evening?

    [/bscolumns][bscolumns class="one_half_last"]Please provide details

    [/bscolumns]

    [bscolumns class="one_half"]Do you currently have an in clinic treatment program?

    [/bscolumns][bscolumns class="one_half_last"]Please provide details

    [/bscolumns]

    [bscolumns class="one_half"]Do have any allergies that would affect your skin? (Dietary or Products)

    [/bscolumns][bscolumns class="one_half_last"]Please provide details

    [/bscolumns]

    [bscolumns class="one_half"]Do you have any medical conditions that would affect the skin care you would use?

    [/bscolumns][bscolumns class="one_half_last"]Please provide details

    [/bscolumns]

    [bscolumns class="one_half"]Do you take any medications that would restrict what you can use on your skin?

    [/bscolumns][bscolumns class="one_half_last"]Please provide details

    [/bscolumns]

    [bscolumns class="one_half"]Does your skin react to hormonal changes?

    [/bscolumns][bscolumns class="one_half_last"]Please provide details

    [/bscolumns]

    Please upload a photo of your skin in natural lighting indicating highlighting any areas of concern with no make on.