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Home
About
Treatments
Conditions
Before & After
Specials
Reviews
Skincare Blog
Contact

Free Skin Evaluation

The following questions are designed to honestly evaluate your skin. Take a look at your skin in the mirror. Then, ask yourself the following questions:

Name*
First Last
Phone*
Email
Best time for contact
What would you like to improve?
- Wrinkles or Fine Lines
- Brown/Dark Spots
- Unwanted Hair
- Loose Skin
- Redness
- Acne
When was the last time you had sun exposure?
Your skin is:
- Very fair, blond or redhead, freckles, burns easly, never tans
- Light skin tone, some tanning but burns easily
- Olive skin tone, some burning, hazel eyes, brown hair
- Medium brown skin, rarely burns, dark hair, dark eyes
- Dark brown skin, rarely burns, dark eyes, dark hair
Sensitive Skin
- My skin is intolerant to irritants and is a combination skin (dry in areas and oily in the T Zone- forehead, nose and chin)
- My skin is intolerant to irritants and is dry to very dry
- My skin is sensitive with redness
- My skin is sensitive, red and flaky
Dry Skin
- My skin is dry and tight
- My skin is dry, tight and itches
- I have eczema/dermatitis/psoriasis
- My skin has a dry, rough feel and needs moisturizing
Oily Skin
- I have oily or combination skin with pimples and/or blackheads
- I have oily, shiny skin and I need to matify it
- I have oily skin that is acne prone
- I have oily skin, but had recent dermatological treatment that left dryness
- I have oily skin with imperfections (spots, pigmentation)
Pigmented Skin
- I have recent dark brown or pigmented spots on my face, neck or hands
- I have pigmentation due to recent scarring or acne
Questions or Comments:
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- I subscribe to receive recurring SMS offers. Message and data rates may apply. Text STOP to opt-out. We will never share or sell your information. T&C/Privacy Policy: https://www.laser-aesthetic-center.com/privacy-policy/

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A member of our staff will contact you soon with more information about your skin analysis and to answer any questions you may have about our available treatments. Feel free to contact us with any questions (630) 920-9155.

Thank you,

LASER AESTHETIC CENTER

*Disclaimer: Please note that there is no guarantee of specific results. Results may vary.

Schedule a complimentary consultation

Full Name*
Email*
Phone*
Treatment
Texting Opt-In
- I agree to receive text messages related to scheduling my appointment. I agree to the Terms of Service and Privacy Policy and understand that message/data rates may apply. I can opt out at any time.

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By submitting this form you agree to be contacted by our staff through phone calls, texts and emails.

950 N. York Rd #104

Hinsdale, IL 60521

Phone: (630) 920-9155

Mon 9:00am – 6:00pm
Tues closed
Weds 9:00am – 6:00pm
Thurs 9:00am – 3:00pm
Friday 9:00am – 2:30pm
Saturdays by appointment only

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