Name * Email *
Phone Number * What color are your eyes? * Light blue, light grey or light green = 0 Blue, grey or green = 1 Hazel or light brown = 2 Dark brown = 3 Brownish/black = 4 What is the natural color of your hair? * Red or light blonde = 0 Blonde = 1 Dark blonde or light brown = 2 Dark brown = 3 Black = 4 Your natural skin color (before sun exposure) is? * Ivory white = 0 Fair or pale = 1 Fair to pale, with golden undertone = 2 Olive or light brown = 3 Dark brown = 4 How many freckles do you have on unexposed areas of your skin? * Many = 0 Several = 1 A few = 2 Very few = 3 None = 4 What happens when you stay in the sun for 45 minutes the first time of the season without any sun protection? * Always burns, blisters and peels = 0 Often burns, blisters and peels = 1 Burns moderately = 2 Burns rarely, if at all = 3 Never burn = 4 Does your skin tan? * Never - I always burn = 0 Light color tan = 1 Reasonable tan = 2 Tan easily= 3 Turn dark brown quickly = 4 Do you turn brown within several hours of sun exposure? * Never = 0 Seldom = 1 Sometimes = 2 Often = 3 Always = 4 How does your face react to sun exposure? * Very Sensitive = 0 Sensitive = 1 Normal = 2 Very Resistant = 3 Never had a Problem = 4 When was the last time you exposed your body to the sun, tanning beds or self-tanning creams? * More than 3 months ago = 0 2-3 months ago = 1 1-2 months ago = 2 Less than a month ago = 3 Less than 2 weeks ago = 4 How frequently do you expose the area to be treated to the sun? * Never = 0 Harldy ever = 1 Sometimes = 2 Often = 3 Always = 4 That's it, just add all of the points from each question, and then choose the corresponding range in the drop down below to see which skin type you have! 0-7 points - Type I Highly sensitive to the sun and always burns 8-16 points - Type II Very sun sensitive and burns easily 17-24 points - Type III Skin can be sensitive to the sun; slowly tans to light brown 26-30 points - Type IV Skin is insensitive to the sun; tans well Above 30 - Type V and VI Completely sun insensitive; deeply pigmented Form Completion
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