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What to Expect

Please allow 72hrs to receive access to your completed skin consult ebook. You will receive access to your 30 day free trial SkinCore portal within 72hrs, where your home care routine, treatment plans, and skincare advice will be.

Single Session Virtual Consultation Includes:

A detailed and comprehensive skin analysis via email
Tailored product recommendations with clear guidance
Consultation Ebook
Unlimited access to the client store and client resource page
For ongoing monthly support become a virtual client!

Products purchased separately.

Please fill out this form, and I will send you your treatment plan and home care routine within 1–2 weeks.

Your Skin Concerns

Select all that apply

Skincare Routine

List your skincare routine & brands (Cleanser, Toner, Hydrator, Moisturizer, Facial Oil, Exfoliants, Serums, etc.) *

Please upload a photo of your current home care products

Upload a clear photo of your products so I can review ingredients and usage.

Photos of Your Skin

Must be in natural lighting (include at least 1 of each: right profile, left profile, front facing, close up of areas of concern)

Upload Photos of Your Skin *

Photos in natural lighting help me give the most accurate recommendations.

Medical History

Do you have any of the following conditions? If yes, please select them.

Your Lifestyle

What is your occupation:

What is your sun exposure?

Do you use sun protection (sunscreen, hats, protective clothing)?

Yes

Do you use tanning beds?

Yes

Do you smoke?

Yes

Do you drink more than 4 caffeinated beverages a day?

Yes

What is your alcohol consumption?

Your Skin Type

Your Skin Type *

Your Skin History

Budget

What is your preferred budget for your skincare routine? *

Under $180

$181–$400

No budget

Full routines typically start at an estimated cost of $180 or more. Please select the option that best fits your comfort level.

Agreement

I have read and completed this questionnaire truthfully. I understand that withholding information or providing inaccurate details about my medical history, allergies, medications, and skincare routines may lead to contraindications or adverse reactions. I agree to inform the technician of any changes in the above information. *

Contact Details

First name *

Last name *

Today's Date *

Month

Day *

Year *

Email *

Phone *

Yes, subscribe me to your newsletter.

Virtual Consultation Fee

Virtual Consultation Fee: $20.00

Products are purchased separately. After payment, you'll receive follow-up instructions by email.

Skin Alchemy HI

AI Assistant

Aloha! I'm Skin Alchemy HI's virtual assistant. I can help with questions about our services, pricing, booking, location, and more. How can I help you today?

Single Session Virtual Consultation Form