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Skin Evaluation Chart

The SKIN EVALUATION CHART is designed exclusively for the professional PREMIERE DERMATECH to evaluate and personalize clientele.

Personalized for:

Personalized By:

Date:

Address:

City:

State:

Zip Code:

Phone Number:

Email Address:

Skin Type:

Skin Characteristic:

Select an option

Skin Tone:

1. Maintenance Needs: I need products to ... Eye Area:

Face:

Anti-Agining:

2. Visible Problems: I can see... Lines

3. Solutions: Products you need... Face

Eyes

4. Preventive Needs: Reduce future damage... Repair

Softening Agent

Mask

Cleanse Face

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