Only for those who have already completed the Acne Quiz and started the program. Progress Photos Photo of the right side Photo of the left side Straight on photo Photo of your most problematic area Acne Check-In Form First Name * Last Name * Email * Phone Are you still breaking out? YesNo Is your skin getting clearer? YesNo How long have you been on your current routine? How many days per week have you skipped your serum or acne med? Write out your morning and evening routines step by step. Please list any additional products that you are using on your face. What products, if any, are burning, stinging or itching? If you answered yes to the above question what number would you give to the sensitivity on a scale of 1 to 10 (1 – minimum and 10 – maximum). 12345678910 Are you dry, peeling, flaky and/or red? YesNo If you answered yes to the above question, please describe. Are you excessively oily? YesNo If you answered yes to the above question, please describe. Have you started any new supplements, vitamins or medications? If so, please list. Have you been able to avoid peanut, soy and dairy products? Have you stopped using fabric softeners and dryer sheets? YesNo Do you take 3 tablets of Zinc Monomethionine? YesNo Additional comments: We will review your file and provide feedback as soon as we receive the check-in form.
