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Question 1

What Is Your Gender?

Male
Female
Prefer Not To Say

Question 2

How long have you been living in your skin?

Under 18 Years
19 to 29 Years
30 to 39 Years
40 to 49 Years
50 to 59 Years
60 or more Years

Question 3

Do any of the below apply to you?

Current Severe Eczema
Active Dermatitis
Open cuts/sores or infected wounds
Are you pregnant/breast feeding or planning a pregnancy?
Are you taking Isotretinoin
None of the above apply to me

Please book in for a consultation at our clinic, we will formulate a regimen suitable for your skin.

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Question 4

How Diligently do you wear sunscreen?

Never
Rarely
Sometimes
Often
Always

Question 5

When you wake up in the morning, how would you best describe your skin?

Normal
Dry
Oily
Combination

Question 6

Select one skin concern that worries you most

Aging
Dehydration
Sensitive
Pigmentation
Acne

Question 7

Have you ever had any adverse reaction to a skin care product/ingredient?

Yes
No

Which product or ingredient caused it?

Benzoyl Peroxide
Salicylic Acid
Retinol

By continuing you agree to the following.

I confirm the information I have provided is accurate. To the best of my knowledge and ability

I confirm that I have filled out this assessment personally. ie. Not on behalf of someone else

I accept that if I buy Active Ingredient products outside of what Skin Truth recommends for my Skin Condition in this assessment, that I do so at my own risk

I agree

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