Follow the steps to successfully complete the questionnaire.

1. Click the ‘Get Form’ button to obtain the form and open it in your preferred editor.
2. Begin by entering your personal information such as your name, address, phone numbers, city, state, zip code, and email address. Ensure all information is accurate to avoid any issues with communication.
3. Provide your date of birth. This information may help tailor services to your age group.
4. Indicate how you were referred to Complexions Rx. Check one of the options: Friend, Walk-by, Mailing, Ad (specify), or Other (specify).
5. In the 'Concerns & Interests' section, describe any specific skin problems or concerns you wish to address, as well as any changes you would like to see in your skin.
6. Answer the questions regarding your current health and lifestyle. Indicate whether you follow a home skin care regimen, list the products you use, and note any allergic or irritant reactions you've experienced.
7. Indicate your sunbathing habits, use of tanning booths, and how regularly you apply sunscreen. Provide details about any chemical peels or facial waxing you have had.
8. List all medications you have used in the past six months, including topical treatments. Check any health conditions that apply to you.
9. Complete the dermatologic history section, where you will note the last time you saw a dermatologist, any skin care treatments you have undergone, and whether you have had any cosmetic procedures or laser surgery recently.
10. Acknowledge and consent to treatment by signing the acknowledgment and treatment consent section. Make sure to read all statements carefully.
11. Once you have filled out all sections, save your changes. You may also choose to download, print, or share the completed form as required.

Start completing your SKIN CARE QUESTIONNAIRE - Complexions Rx online today for personalized skin care solutions.