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This information you provide by answering the following questions will allow us to determine your skin type according to the Fitzpatrick skin type scale, which ranges from Very Fair to Very Dark. The main factors that influence skin type are: genetic disposition, reaction to sun, and tanning habits.

Your full name:
E-mail address:

Genetic Disposition:

What is your eye color?

Light blue, light gray, light green
Blue, gray, green
Blue
Dark Brown
Brownish black

What is your natural hair color?

Sandy, red
Blond
Chestnut/Dark blond
Dark Brown
Black

What color is your non-exposed skin?

Reddish
Very pale
Pale with beige tint
Light brown
Dark brown

Do you have freckles on unexposed areas?

Many
Several
Few
Incidental
None

Reaction to Sun Exposure:

What happens when you stay in the sun too long?

Painful redness, blistering, peeling
Blistering, followed by peeling
Burns sometimes, followed by peeling
Rarely burns
Never burns

To what degree do you turn brown?

Hardly or not at all
Light color tan
Reasonable tan
Tan very easy
Turn dark brown quickly

Do you turn brown within several hours after sun exposure?

Never
Seldom
Sometimes
Often
Always

How does your face react to the sun?

Very sensitive
Sensitive
Normal
Very resistant
Never had a problem

Tanning Habits

When did you last expose your body to sun or tanning booth/cream?

More than 3 months ago
2-3 months ago
1-2 months ago
Less than 1 month ago
Less than 2 weeks ago

Did you expose the area to be treated to the sun?

Never
Hardly Ever
Sometimes
Often
Always





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