Facial Questionnaire FACIAL QUESTIONNAIRE* Name & Surname* Contact Number* Your Email Address* Your Date of Birth* What is your Skin type? Normal Dry Combination Oily Sensitive * Do you have a Skincare Regime at home, please ellaborate?* What are your Primary Skin Concerns? Dryness and Dehydration Acne and Breakouts Oiliness Uneven Skin Tone Signs of Skin Ageing Sensitivity and Redness * What is your Age?* What would you like the Therapist to Concentrate on During your Treatment?