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Booking

Please complete the following form to start your skincare consultation with our expert skin specialists.

Once completed and you have been assessed for suitability by our expert specialists, you will receive product recommendations in an email. Please note, online consultations are approved Mon-Fri 9-5pm. If completed after 3pm then you will be assessed on the next working day.

* = required information

About You

Address

Contact Information

Preferred contact method *

EmailPhone

Medical History

Do you have any Medical Conditions? *

YesNo

Are you taking any medication? *

YesNo

Do have any allergies? *

YesNo

Are you allergic to nuts? *

YesNo

Are you currently taking aspirin? *

YesNo

Are you currently pregnant or breastfeeding? *

YesNo

Medical History

Do you have any of the below skin conditions?

PsoriasisEczemaRosaceaAcneOther

Have you ever experienced skin sensitivity to any products or facial treatments? *

YesNo

Have you had any advanced facial treatments in the last 6 months?

LaserIPLPeelsMicrodermabrasionInjectablesMicro needlingOther

Do you have any previous history of skin cancer? *

YesNo

Would you burn within 20 minutes in the sun without SPF?*

YesNo

What is your skin type?*

Very FairFairCream/WhiteOliveDark BrownBlack

How do you find your skin? *

OilyCombinationSensitiveOliveDryNormal

Other Information

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