Sophyto Organics - Professional Certified Organic Skin Care Products

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Professional Organic Skin Care Products

pH: healthy skin solutions

sense and sensitivity

info center: skin questionnaire

Use the form below for your FREE personal skin care analysis carried out by a professional Bio Medical Esthetician. The results will help you understand your skin-related problems. You will receive an evaluation and product recommendation specifically designed for you. This is NOT an auto-responding web page, but completely personalized, therefore each analysis requires at least 24hrs prior to analysis and recommending skin care products. We understand how difficult it is to choose the right products. This skin care analysis will help you make informed decisions about how to handle your home skin care. Please make sure that you give an answer to every question, all answers are required so that we can perform a complete evaluation of your skin. Privacy Statement: The information you provide is completely confidential and used only for analysis by our professional Bio Medical Esthetician. * = Required Fields Your Details
First Name: *	Last Name: *
Full Address:	Country: *
Phone: *	Age: *
Tell us about your climate:	Email Address: *
Lifestyle Background
Type of work you do:	Stress level:
Quality of Sleep:	Do you smoke:
How many glasses of water do you drink a day?
Do you drink alcohol?	Weekly intake
Do you drink caffeinated beverages?	Weekly intake
Do you follow a restricted diet?	Describe
Are there any particular foods you overindulge in?	Describe
Do you exercise or participate in sports?	Describe
Health Background
Are you under the care of a physician?	Describe
Have you undergone any recent surgeries?	Describe
Do you suffer from a specific health condition?	Describe
How long ago was it diagnosed?
Are you taking any medications (prescriptions/herbs/supplements)?	Describe
Do you have any allergies?	Describe
Have you ever had blisters or cold sores?	Describe
Do you scar easily?
Do you suffer from keloid scars or poor scarring?	Describe
Skin Daily Routine
Do you clean your skin with water?	What is the temperature of the water you cleanse with?
Please list all products you currently use on your skin:
Do you currently use any Retinoid or Vitamin A derived product?	Describe
Do you currently use any alpha hydroxy and/or beta hydroxy products?	Describe
Do you sunscreen daily?	Indicate SPF
Do you tan or go to a tanning salon?
Have you previously had any cosmetic procedures done?
Please, indicate whether you have had any of the following: Laser Resurfacing Microdermabrasion Facial peel/chemical exfoliation Facelift Dermabrasion Eyelift Other	If yes, how long was the procedure performed?
Skin Diagnosis
What is your hair color?	What is your eye color?
How much sun exposure do you get in an average week:	Time of day are you in the sun:
Do you use sunscreen?	SPF no?
pH Acid Mantle Profile
How does your skin feel?	Do you ever experience flakiness?
Does your skin feel tight?	Does your skin become dry easily?
Does your skin feel wet/sticky?	Does your skin shine during the day?
Indicate the size of your pores:	Do you ever break out?
I break out
Type of breakouts (mark all that apply to you) Blackheads Small Whiteheads (miliums) Large Whiteheads Papules Pustules Cysts
How many days does it take for a pimple to go away?
Sensitivity Profile
Is your skin sensitive or easily irritated by products?
Is your skin sensitive to pressure?
Do you bleed/bruise easily?
Do you blush easily?	Describe
Does your skin tend to get irritated?	Describe
Have you ever experienced sensitivity/allergy to any skin care product or active ingredient?	Describe
Do you suffer from telangiectasias (spider veins)?	Describe
Do you suffer from Rosacea?
Have you ever been prescribed steroids?	Describe
Pigmentation Profile
Do you have any hyperpigmentation?	Describe
Have you ever used hydroquinone?	Describe
Have you ever been diagnosed with Vitiligo?	Describe
How frequently do you expose yourself to the sun?
Do you protect your skin from televisions, computers and/or lights radiation?
Almost Done Please choose up to three skin care issues that you would like help with: Clear up Acne eruptions Clear up blackheads Minimize size of pores Decrease oilyness of skin Diminish the appearance of capillaries on the face Lighten skin complexion or hyperpigmentation Restore skin elasticity Hydrate the skin Smooth skin texture Diminish flakiness of skin Lighten Acne scarring Diminish wrinkles and fine lines Pre-facial surgery skin preparation Post-facial surgery skin care No special results, just a regimen for my skin Please take a moment to list the products you are currently using along with an example of your daily skincare routine.