Online Skin Consultation



    Have you used Alpha Hydroxy Acids (AHA) or Glycolic products (BHA) in the last 48-72 hours?*

    Are you using or have used in the last 6-12 months Retin-A, Renova, Accutane(an oral form of Retin-A)?*

    Are you using any skin thinning products or drug, e.g hydrocortisone cream?*

    Are you pregnant/planning or nursing?*

    Are you exposed to the sun or sunbeds?*

    Do you suffer from Epilepsy or Diabetes?*

    Are you currently taking and medications? If yes please list:*

    Are there other medical conditions or issues that your therapist should be aware of? If yes please list:*

    Have you ever been treated for Cancer? If yes, when and what types of therapies were used?*

    Do you wear contact lenses?*

    Do you have any Allergies e.g Aspirin, allergies to ingredients in products, If yes please list:*

    Do you have any skin conditions such as psoriasis or eczema?*

    Do you have any recent scars(under 6 months old) or suffer from keloid scarring?*

    What is your stress levels between 1-5?*

    Do you exercise and how often?*

    How much sleep do you get per night?*

    How much water do you drink a day?*

    Do you have a healthy diet?*

    Are you taking the contraceptive pill?*

    Do you smoke? If yes how many:*

    Do you consume a lot of sugar?*

    Do you consume a lot of dairy?*

    Do you take any vitamins or supplements? Please list if yes:*


    What is your main concern with your skin?*

    What would you like to see achieved with your skin?*

    Have you ever had a Chemical Peel, Laser, or Microdermabrasion? If yes which treatment and when was it last done?*

    What skincare products are you currently using?*

    What Brand of skin products are you currently using? Please list:*

    Do you use a SPF every day?*

    Do you include retinol products in your skin routine?*

    How sensitive is your skin? Please tick:*

    What Areas of concern do you have regarding your skin: Please tick any that apply*

    Do you get Any of the following: Please tick:*

    Do you do a AM and PM skin routine? Please tick:*

    Do you wear Make up every day?*

    Do you wear a Mineral based Make up?*