Skin Analysis Form

Skin Analysis Form

Please submit online. If you prefer, you can printout, email, fax or post this form to us. All skin preparations are prescribed on an individual basis Please incl. £27.50 Sterling Fee. When Skin analysis complete, a full report and rec. on treatments and prices will be sent. Please pay analysis fee of £27.50 in the product page, or send to the address below. Alternatively, the analysis form can be e-mailed and fee paid by credit card. If you require any further information about this process please e-mail or telephone us at 01475 724629. A full analytical report will be e-mailed or sent to you detailing recommended treatments. Should you decide to proceed with the treatments you may order via e-mail or by post, including your cheque.
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Genetic History
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Visual Observations
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IF YES for above, please give further information in the additional info section e.g. is acne pustular, weeping, blackheads, what areas are affected, chin, forehead, around cheeks, what treatment have you been using and for how long etc. Please give as much information as possible.
Manual Observations
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Pinch and lift the skin between the forefinger and thumb, see how long the skin takes to return to normal.
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Lift the skin and feel the thickness with the fingers.
Supplementary Information
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The Sun
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Thank You. Please Click the following button to send the form.