Questionnaire | Post-Program Consultation | General

4 Month Skin Fitness Program

Diagnostic Questionnaire
General

Post-Program Consultation

Name

How far are you into the Skin Fitness Program?

Have you reduced use of other cosmetics? Please detail the extent of this - e.g. totally or reduced use by how much?

How many times a day have you been using JooMo Skin Supplements?

Please give details of *any* drugs you are taking currently. This includes ones started since the last questionnaire, and whether you have reduced/increased dosage during the same period.

Q1: Please list each symptom you are experiencing due to your skin at the moment.

(eg. sensitive skin, red and inflamed skin, pustules, whiteheads, deep itching, flaking skin, infections, split skin, oozing sores, bumpy skin etc.)

Q2: From 0-10 (10 being awful and 1 being non-existent) please rate the severity of each symptom selected in Q1.

Q3: Please give details of *any* health problems that you have noticed a change in during the Skin Fitness Program. These could be ones you stated in your original questionnaire.

4 Month Skin Fitness Program

Diagnostic Questionnaire
General

Post-Program Consultation

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4 Month Skin Fitness Program

Diagnostic QuestionnaireGeneral

Post-Program Consultation

Message us

Diagnostic Questionnaire
General