What is your skin type?

Please note: Discontinue use of any facial products immediately if you experience any discomfort and see your physician or dermatologist.  You must consult your physician before starting any new skin care routine!
1.  Are you on any prescription medication?





If yes, please consult your physician before using new skin care products.

2.  Do you have any allergies (food, drug, make-up, dust, etc.)




If yes, please list below:



3.  Do you drink a lot of coffee, tea, cola, etc. (once a day, min.)




4.  At the end of the day your skin is:




5. Stand in the bathroom (or another well lighted place) and LIGHTLY pinch your cheek.  Look in the mirror.  Is the skin texture:






6.  Do you get breakouts or blackheads?



If yes, where?




If yes, when?





7. Do you get white bumps that aren't pimples and don't fade?




8.  Does your skin ever crack? 





If yes, where?



If yes, when?




9.  What products are you currently using on your skin (item and brand)?






10.  Do you get facials?






11. Is your face shiny at the end of the day?


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dry
oily
crepy, like fine parchment
full (like an orange peel)
no
yes
no
yes
no
yes
birth control
no
yes
monthly
all the time
when I'm stressed
no
yes
no
yes
seasonally
when I'm stressed
all the time
no
yes - sometimes
yes - regularly
yes
no