Free Skin Assessment
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Question 1 of 12
Full Name
Question 2 of 12
Email
Question 3 of 12
Phone Number
Question 4 of 12
What are your main concerns with your skin and what are the reasons you would like to change/improve this?
Question 5 of 12
What is your Date of Birth?
Question 6 of 12
Are you experiencing any of the following? Tick all that apply!
Ageing Lines & Wrinkles
Uneven Skintone/ Pigmentation/ Sun Damage
Eczema/ Dermatitis or Sensitivity
Dry/ Tight, Dehydrated
Rosacea/ Redness/ Flare-ups
Redness/ Itching/ Burning Sensations
Oily/ Blackheads/ Congestion
Other
Question 7 of 12
How long have you been experiencing/noticing this?
Question 8 of 12
What is your current skincare routine? Please list all products, including brands, and the order and frequency in which you use them.
Question 9 of 12
What other salon treatments, products, or home devices have you tried in the past, and what results did you get?
Question 10 of 12
Which options/recommendations would you like me to cover?
All Suitable Options: Salon Treatments, Homecare Products & Home Devices
Salon Treatments & Homecare Products
Homecare Products & Home Devices
Homecare Products only
Question 11 of 12
Any further questions or concerns with your skin?
Question 12 of 12
To gauge how critical it is for you to address your current skin concerns, please rate their importance on a scale of 1 to 10. This will help me understand your level of urgency and commitment to finding a solution.