Name
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First Name
Last Name
Date of Birth
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Email
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Contact Number
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Preferred method of contact for video call:
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Whatsapp
Google Meet
Are you currently pregnant, trying to conceive or breastfeeding?
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Are you on any medications, including the pill,HRT or antibiotics? (If yes please give details)
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Have you ever been prescribed medication for a skin issue? ie Roaccutane? Please give details.
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Do you have any allergies that you are aware of?
Have you ever had an adverse reaction to a product or ingredient?
Describe your current skincare routine in as much detail, both morning and evening, include every single product that you use on your skin.
Do you take any supplements?
Describe your skin in your own words? eg. tight, oily, breakouts, dull, red, irritated etc
What is your main concern, what would you like to improve about your skin? Is there a specific area that you are hoping to improve?
How does your skin feel after you cleanse, or after you have a shower? does it feel tight, dry, oily, or normal?
How much daylight are you exposed to? do you work outside or spend a lot of time playing sport or training outdoors?
How many hours of artificial light from devices are you exposed to? To help you check, use the search option in your phone's settings and search for digital wellbeing this will tell how long you spent on your phone that day.
How much time do you wish to spend on your skin routine every AM and PM?
Do you feel like your skin is specifically affected by your menstrual cycle, peri-menopause, menopause, medications, lifestyle, occupation or any other factors? If yes please provide me with as much information as possible
How did you hear about River Skincare??
