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HOME
ABOUT US
PROCEDURES
CONDITIONS
- ACNE
- AGING
- EXCESSIVE SWEATING
- HAIR LOSS
- MIGRAINES
- WRINKLES
- THIN LIPS
OUR WORK
BLOGS
BOOK NOW

SKINCARE TREATMENTS ASSESSMENT

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SKINCARE TREATMENTS ASSESSMENT

Skincare Treatment Assessment

Skincare Assessment Test

Step 1 of 2

50%

Tell us about your skin.

What is your biggest skin concern?

Acne

Aging/Wrinkles/Fine lines

Oily Skin

Dry Skin

Scars or age spots

How long have you been suffering with this skin concern?

1-5 years

5-10 years

15-20 years

My whole life

Is your skin concern genetic?

Yes

No

I don't know

Have you had any medical aesthetic procedure done in the past?

Yes

No

How did you enjoy it?

Loved it

Didn't get the results I wanted

How soon do you want to get get a skincare treatment?

Immediately

Within the next week

Within the next month

I need a consultation

Do you have any of the following?

Cancer

Diabetes

Skin diseases

Skin lesions

HIV/AIDS

Pregnant/Breastfeeding

Other

None of the above

Name

First Last

Email

Phone

Need help picking a treatment? Call us at 613-818-9952

BCI Clinic. All Rights Reserved.

1530 Merivale Road. #208

Nepean, Ontario K2G 3J7

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