Free Confidential Laser Hair Removal Consultation

1. On what area of your body would you like to have laser hair removal performed?: *

2. What color is your skin in this area?: *

Black

Dark Brown

Light Brown

White

4. What is your skin type in the area you are considering to have laser hair removal?: *

Type I- Always burn, never tan (extremely fair skin/blond hair/blue/green eyes)

Type II- Usually burn, tan less than about average (fair skin, sandy brown to brown hair, green/blue eyes)

Type III- Sometimes mild burn, tan about average (medium skin, brown hair, green/brown eyes)

Type IV- Rarely burn, tan more than average (olive skin, brown/black hair, dark brown/black eyes)

Type V- Moderately pigmented, tans profusely (dark brown skin, black hair, black eyes)

Type VI-Deeply pigmented, never burns (black skin, black hair, black eyes)

6. Do you currently have a suntan?:

Yes

Slight

7. Have you recently used Accutane?:

yes

8. Are you taking any medication which could cause photosensitivity?:

Yes

Don’t Know

9. Are there any other specific questions you have about laser hair removal?:

Name: *

Email: *

Where would you like the results of your analysis sent to (please provide a valid email address)

Will laser hair removal work for you?