|
Please answer the following questions by filling the number which best describes you in the designated spaces. Your clinician w
|
|
|
My ethnic origin is closest to:
|
|
|
My eye color is:
|
|
|
My natural hair color at age 18 was:
|
|
|
The color of my skin that is not normally exposed to the sun is:
|
|
|
If I go out into the sun for an hour or so without sunscreen and have not been out in the sun for a week, my skin will:
|
|
|
When was the last time the area to be treated was exposed to natural sunlight, tanning boots, or artificial tanning cream?
|
|
