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Due to the nature of this form, it can only be filled out on a laptop or desktop computer.
Please fill out this to the best of your ability
Please choose whether you've had any of the following
What is the natural color of your hair?
What is your eye color?
Chestnut, dark blonde
Light blue, Gray, Green
Blue, Gray, Green
What is the color of sun unexposed skin areas?
Pale with beige tint
How many freckles on unexposed skin areas?
What happens when you are in the sun TOO long without sunblock?
Painful redness, blistering, peeling
Blistering followed by peeling
Burns, sometimes followed by peeling
Never had a problem
How well do you turn brown?
Hardly or not at all
Light color tan
Tan very easily
Turn dark very quickly
Do you turn brown within one day of sun exposure?
How does your face respond to the sun?
When did you last expose yourself to the sun or artificial sun treatments?
More than 3 months to go
2-3 months ago
1-2 months ago
Less than 1 month ago
Less than 2 weeks ago
Do you expose the area to be treated to the sun?
00-07 points = Skin type I
08-16 points = Skin type II
17-25 points = Skin type III
25-30 points = Skin type IV
30-40 points = Skin type V & VI
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