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Part 1 Questionnaire

Part 2. 1. How sensitive is your skin? a. Little to no sensitivity……………….…1 b. Mildly sensitive…………….….…...….2 c.. Moderately sensitive…………….….. 3 d.. Very sensitive……………………..….4 2. How often do you break out? a. Rarely, if at all……...……………….…1

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Part 1 Questionnaire

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  1. Part 2 1. How sensitive is your skin? a. Little to no sensitivity……………….…1 b. Mildly sensitive…………….….…...….2 c.. Moderately sensitive…………….….. 3 d.. Very sensitive……………………..….4 2. How often do you break out? a. Rarely, if at all……...……………….…1 b. Monthly………….………………….….2 c.. Weekly……………...………………... 3 d.. Daily………...……………………...….4 Part 2 Total 1. Do you have lines around your eyes or mouth? a. No…………………………………………..……….2 b. Yes………………………………………………….1 2. Have you noticed loss of firmness/sagging skin? a. No…………………………………………..……….2 b. Yes………………………………………………….1 3. Do you have visible age spots or sun damage? a. No…………………………………………..……….2 b. Yes………………………………………………….0 4. What is your age range? a. Under 20………………………………………...…10 b. 20 - 29………………………………..…………..….8 c.. 30 - 39……………………………………..…….….6 d.. 40 - 49………………..……………………….…….4 e. 50 +…………………………………………..……...2 Part 1 Total Part 1 Skin Sensor Guide Cheek Sensor 5 11 15 Forehead Sensor 5 10 15 Part 1 Questionnaire

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