the skin assessmentcomplete your skincare assessment & we’ll get back to you with a customized ritual Name * First Name Last Name Email * Phone * (###) ### #### best time of day to reach you We will give you a quick call to review your results and provide suggestions for your routine. morning before noon afternoon between noon and 3pm evening hours between 3-6pm Age * 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 gender * female male prefer not to disclose skin type Skin Type: oil levels * select which best describes your skin My skin is very oily with active acne and inflammation My skin is very oily with acne and/or congestion (blackheads) My skin is oily with congestion, milia and/or enlarged pores My skin is oily tendency with enlarged pores and unrefined skin My skin is oily tendency prone to breakouts (hormonal) Skin Type: dryness levels * select which best describes your skin Rosacea and/or acne rosacea Very sensitive and reactive Naturally sensitive with red flushes Reactive, sensitised skin with blotchiness Balanced/Not Sensitive How hydrated do you feel your skin is? * select which best describes your skin Very dehydrated Quite dehydrated Slightly dehydrated Fairly hydrated Well hydrated skin condition select all that apply for each concern Acne & Hormonal Breakouts * are not a problem occasionally consistently an issue Pigmentation & Brightness * Sun or Age Post-Acne Scarring Dullness I'm Clear Lack of Plumpness * Cheekbone Area Naso-Labial Area Neck I'm Plump Fine Lines & Wrinkles * Forehead Naso-Labial Area Neck I'm Smooth Skin's Tone * Cheekbone Area Jawline Neck I'm Toned The Eye Area * Dark Circles Puffiness Dehydration Wrinkles I'm Perfect current skincare ritual How long per day do you spend on skincare? * 1-15 minutes 15-30 minutes 30-60 minutes 60+ minutes Do you currently use retinol? * quick note: we recommend waiting 2 weeks between using retinol treatments and starting some products. If you currently use retinols, please let us know to avoid irritation. yes, but I can give it up no yes & it's a must-have Are you interested in eastern healing to coordinate with your skincare regimen? * yes no What brand or brands of products do you currently use? * We’ve got your info! We’ll review your skin assessment and get back to you with custom recommendations asap.Meanwhile, feel free to start browsing the line!
