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PERSONAL SKIN DIAGNOSIS
  1. In order to create your personal profile the best way possible, please answer all the following questions about your skin type, your lifestyle factors. This will help us to define your skin's identity so we can make recommendations tailored to you and your skin.
  2. First name(*)
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  3. Last name
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  4. Email(*)
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  5. Phone/Mobile
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  1. Please select:(*)

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  2. What is your age?(*)




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  1. How would you describe your skin?(*)



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  2. What is your skin type?(*)





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  3. Skin sensitivity:(*)


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  4. Food intolerance - comment
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  1. Skin moisture level:(*)

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  2. Wrinkles: (Check all that apply)



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  3. Loss of firmness: (Check all that apply)


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  4. Do you suffer from: (Check all that apply)



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  1. What is your lifestyle? (Check all that apply)(*)




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  1. Describe your diet (Check all that apply)














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  2. Submit your answers