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Unformatted text preview: s, light spots or uneven skin tone ■ Yes, large spots or blotchy skin 7. What is the texture and tone of your skin? ■ My skin feels smooth and looks even
and luminous ■ My skin feels smooth but has lost its luminosity
■ My skin feels slightly rough and has lost ■ its luminosity
My skin feels rough, looks uneven,
and has lost its luminosity 8. What are your skin care goals?
(Please check all that apply.) ■ Reduce/prevent the appearance of fine lines
and wrinkles ■ Reduce under-eye puffiness and dark circles ■ Achieve a more even-toned complexion ■ Improve texture and radiance ■ Improve firmness ■ Reduce blemishes ■ Reduce dryness
9. Are you interested in non-invasive alternatives to any of
the following dermatological/cosmetic procedures?
(Please check all that apply.) ■ Yes, non-invasive alternatives to a mini face-lift
■ Yes, non-invasive alternatives to linerelaxing injections ■ Yes, non-invasive alternatives to an eyelift
■ Yes, non-invasive alternatives to collagen injections ■ Yes, non-invasive alternatives to a chemical peel ■ Yes, non-invasive alternatives to microdermabrasion ■ No, none of the above ©2009 All rights reserved. Printed in the USA. LA3276A LA3276A 40-0694 ÉValUation Personnelle De la PeaU PoUr :
Nom : ____________________________________________________________________________________
Adresse : _________________________________________________________________________________
Ville : _________________________________________ Province : _____ Code postal : _______________
Adresse électronique : _______________________________________________________...
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