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Skin Care Analysis

pH ADVANTAGE Comprehensive Skin Care Analysis

This is an exercise that will assist us in determining what your individual skin care needs might be, based on a series of comprehensive questions.

Many people believe they possess healthy skin. While that often times is the case, there are always improvements that can be made to your daily skin-care regimen that will increase your overall skin�s health and appearance. This fast, easy and all encompassing questionnaire is an opportunity to see what you can do to improve everything about your skin.

At the end of the exercise we will recommend products and offer solutions and education regarding your skin that will assist you in achieving the perfect skin care regimen.

1. What is your gender?

2. Which of the following best describes your age range?

The remaining questions will allow us to accurately and correctly recommend products based on your answers

3. Which of the following describe a skin care concern that you might be experiencing? (Check all that apply)
Fine lines and wrinkles (Example)
Uneven Skin Tone (Example)
Dehydrated Skin (Example)
Clogged Pores (Example)
No real problems to speak of, I am just looking to maintain healthy skin (Example)

4. Which of the following designations and description best describes your skin tone and complexion.
The Fitzpatrick Scale
Skin Type Appearance Reaction to Sun Exposure
Type I
Fair, blond, or red hair; light-colored eyes; freckles common Always burns, never tans
Type II
Fair skinned, light eyes, light hair Burns easily
Type III
Very common skin type; fair, variable eye and hair Sometimes burns, gradually tans
Type IV
Mediterranean Caucasian, medium to heavy pigmentation Rarely burns, always tans
Type V
Mideastern Caucasian, medium to heavy pigmentation Tans
Type VI
Black skin, rarely sun sensitive Tans easily

5. Which of the following specialty items would you be interested in adding to your daily regimen? (Check all that apply)
Eye Product (Specifically designed to treat delicate skin area around eyes including puffiness, dark circles and bags)

Lip Product (Use to protect, treat and repair delicate lip area)

6. Have you used injectible muscle relaxants or toxins such as Botox and Reloxin?

7. Have you used injectible fillers such as Restylane, Juvaderm or Hylaform?

8. Do you currently use a product that contains SPF on a consistent basis when venturing outdoors?

9. Do you take oral supplements?

10. Are you allergic to any of the following or do you get an allergic reaction from any of the following?
Glycolic Acid
Salicylic Acid