Skin Assessments

Skin Assessments

Please answer the following questions so that there will be a better understanding of your current skin condition, general health and lifestyle, thereby allowing for better assessment and analysis of your skin care needs.

Items marked with an * are required fields.

* Gender

Please check if presently using any of the following.

Ethnic Background

I have had the following procedures

Which conditions do you want to improve?

  • Cause

    Are you using any other lighteners?

    Type of sun protection

    Do you sunbathe or participate in outdoor activities?

  • Do you have or have you ever had acne?

    Acne Conditions

    Are you presently under a doctor's care?

Have you ever had an allergic reaction to any skin product or cosmetic?

Specific skin problems

Skin Texture

Skin Irregularities

Do you take recreational drugs?

Have you ever had Herpes (cold sores)?

Have you ever been treated with Zovirax or any medication for Herpes?

Do you have epilepsy or diabetes?
(If yes, you will need a doctor's certificate for the use of certain products and treatments!)

Are you presently under a physician's care for any reason?

Do you use Biore or snore strips?

Are you allergic to aspirin?

Do you have any other allergies?

Do you smoke?

Do you take nutritional supplements?

Are you on a diet?

Do you exercise?

Are you currently having any facial treatments done?

Have you had electrolysis or waxing in the past week?

Do you have those services done?

Have you had permanent cosmetics?

How is your general health?

Female Clients Only:

Are you on hormone replacement therapy?

Are you presently taking birth control pills?

Are you pregnant or planning to be?

Disclaimer: Answering these questions provides information that will act as a general guide to suggest possible use of some home care skin nutrition and possible referral for professional treatments. In no way is Rhonda Allison Clinical Enterprises able to diagnose, treat, or prescribe for specific skin conditions.