Skin Analysis Survey Name(Required) First Last Phone(Required)Email(Required) What products are you currently using?(Required) Have you experienced sensitivity from any skincare products?(Required)YesNoHow often do you exfoliate?(Required) Are you using any topical prescriptions from a physician?(Required)YesNoHow often is your sun exposure, and what is the duration?(Required) Do you wear sunscreen?(Required)YesNoIf yes, SPF and brand?(Required) Do you follow any particular diet?(Required)YesNoDo you indulge in spicy foods, caffeine, red wine?(Required)YesNoDo you suffer from allergies?(Required)YesNoDo you experience bouts of skin blotching, burning, or itching?(Required)YesNoHow often do you notice redness in the skin?(Required) Have you developed spider veins on the face?(Required)YesNoCAPTCHA
