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What is your approximate age? |
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| 2. |
Is your skin normal, slightly dry, or extremely dry, slightly oily or extremely oily, T-zone only? |
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| 3. |
Is the texture of your skin more like an apple peel or an orange peel? |
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| 4. |
Do you break out? If so, how often and how much? Are they pustules, cysts, under the skin whiteheads, rashy or itchy? |
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| 5. |
Is your skin particularly thin or delicate (i.e. can you use a scrub)? Any visible broken capillaries? |
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| 6. |
Any allergies or skin sensitivities we should know about?
Are you allergic to wool or lanolin? |
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| 7. |
When is the last time you used a basic bar of soap on your face? |
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| 8. |
Do you wear foundation or primer? Liquid, powder, or both? Please tell us all products of this type. |
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| 9. |
Do you use any products with chemical exfoliants (AHA, Retin A, retinoids, glycolic, salicylic acid?) |
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| 10. |
Please list each and every product you use on your skin now, morning and evening. Please be as specific and detailed as you can about each individual thing you use on your skin, and how you apply and remove each one. |
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| 11. |
What would you like to improve about your skin? |
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| 12. |
What is the climate where you live and how much time do you spend on outdoor activities? |
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| 13. |
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What is your name? |
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What is your email address? |
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Please tell us who forwarded you this analysis form |
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