Welcome

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About your health
Do you know which is your skin type?
- Yes
- No
Skin type
- Oiliness
- Acne - inflammations
- Cystic acne
- Dry
- Normal - mixed
- Dehydrated
- Sensitive
- Skin with Hyperpigmentation
- Vascular vessels
- Wrinkles
- Relaxation
Have you had clinical diagnosis about your skin type?
- Yes
- No
Have you had any surgery in the last 9 months?*
- Yes
- No
Please explain*
Have you had any health problems in the past or in the present?*
- Yes
- No
(Cancer, malignancy, diabetes, epilepsy, cardio-logical problems, hormonal disorders)
Please explain*
Do you homeopathy?*
- Yes
- No
Do you have metal parts on your body, or pacemaker?*
- Yes
- No
Do you take any medicines?*
- Yes
- No
Do you have any allergies?*
- Yes
- No
especially in Salicylic Acid?
Do you often get herpes or choroid?*
- Yes
- No
Are you claustrophobic?*
- Yes
- No
Do you smoke?*
- Yes
- No
Do you exercise regularly?*
- Yes
- No
Have you noticed any rush or any kind of reaction to any of the below?
- Cosmetics
- Pollen
- Medicines
- Hydroxy acids

About your skin
Do you have any specific skin problem on your face or body?*
- Yes
- No
Please explain
Does your skin look very oily during the day?*
- Yes
- No
Have you noticed any rush on your body or face?*
- Yes
- No
Do you feel your skin dry?*
- Yes
- No
What do you usually do for your daily care?
- Cleanser
- Tonic
- Moisturizing cream
- Mask
- Peeling
- Eye cream
- I also do a daily care for my body
Body daily care, please explain
Have you ever had a chemical peel or Dermabrassion?*
- Yes
- No
Have you ever done a healing program on your face or body in the last year?*
- Yes
- No
Please explain
Do you epllate your face or body?*
- Face
- Body
Do you get tan or sunburn?
- Tan
- Sunburn
Do you get sunbath or solarium
- Sunbath
- Solarium
How much water do you drink per day?*
- Less than 1lt.
- 1lt. or 2 lt.
- More than 2lt.

Final questions
Please select*
- Ladies
- Gentlemen
Is your period stable?*
- Yes
- No
Do you take contraception peels?*
- Yes
- No
Are you pregnant or trying to be?*
- Yes
- No
Breastfeeding?*
- Yes
- No
Are you in premenopausal?
- Yes
- No
How do you usually shave?*
Do you get a rush after shaving?*
- Yes
- No
Have you noticed any hair that grow internally on your skin?*
- Yes
- No
If there are specific improvements you are seeking for your body or face, please let us know.
Treatment and skin plan
- I don't have a treatment plan yet
- I have been informed in detail about the treatment process and how I should take care of my skin in the up-coming days.
Name
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Personal information