Skin Care Assessment

Complete your assessment to continue to secure payment. Our clinical team will review your answers before treatment is approved.

Loading your selected treatment…

Step 1 of 6

Your details

Please enter your details so our prescribing team can review your request safely.

Legal first name Legal last name

Email address

Phone number Date of birth

Sex assigned at birth

Medical and safety screening

Please tell us about any relevant medical history so our prescriber can assess suitability.

Do you have a history of asthma? Please tell us more Do you have any other significant medical conditions or illnesses? Please tell us more Do you take any prescription medication? Please tell us more Do you take any over the counter medicines, supplements, or vitamins? Please tell us more Do you have an allergy to any of the following? Please tell us more

Are you pregnant or planning a pregnancy soon? Are you using contraception? Are you currently breastfeeding?

Skin Care Assessment

Your details

Delivery address

About your skin

Current and previous treatment history

Medical and safety screening

Photos and confirmation