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The betterskin.com.au team

Name:
Email Address:
Skin Type: Dry
Dry / Normal
Normal
Oily / Normal
Oily Skin Conditions: Dehydration
Pigmentation
Flakiness / Echzema
Acne
Sensitivity
Congestion
Premature Ageing Do you have regular facials? Yes
No What products do you use? Cleanser
Toner
Exfoliator
Moisturiser
Serum
Masque
Eye care
Body care
Sun care
Make-up Name the Brands and Products you use:
Medical History Do you use Accutane, Retin A, Renova, Adapalene or any other prescription skin products? Yes
No In the last 3 months? Yes
No Do have any allergies and have you ever reacted to a cosmetic product? If yes Please Specify:
Within the last year, have you been under a dermatologist or other physician's care? Yes
No Are you pregnant or trying to become pregnant? Yes
No Your Question?
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