Know your skin

Fill out the questionnaire according to the characteristics of your skin and tell you how this and the most appropriate treatment for her. Please note that fields marked with * are required fields. If you wish you can send us some photos to for a better diagnosis.


Firstname and Lastname* 
Province*  Country*
Age SexHair Color
Do you burn easily when sunbathing?Skin color
Have you had acne in adolescence?Would you continue dating pimples?
Do you have dandruff on your head?If so
Does your skin itch?Do you feel tension?Are you itchy scalp?
Are you in menopause?
How baby had eczema or a tendency to skin problems?
Do you have a hobby where you handle solvents or chemicals?
Do you have redness in the skin?In what areas? Do you have pimples?
Do you have red veins (spider veins)?Do you have bags or dark circles?
What is the purpose of your visit?
Do you want to make an appointment?


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