business P

Skin Type Evaluation Record

Date: ____________ Phone: ______________________

Name: ______________________________________

Address: ____________________________________

City: ______________ State: ________ Zip: ________

Email Address: _______________________________

Score 0 1 2 3 4 Score GENETIC PREDISPOSITION

What is the color of your eyes? Light Blue, Grey or Green

Blue, Grey or Green

Blue Dark Brown Brownish Black

What is the natural color of your hair?

Sandy/Red Blonde Chestnut/Dark Brown

Dark Brown Black

In your unexposed areas, what is the color of your skin?

Reddish Very Pale Pale with Beige Tint

Light Brown Dark Brown

What amount of freckles do you have on your unexposed areas?

Many Several Few Incidental None

TOTAL: _____________

TOTAL: ________________ Tanning Habits

When did you last expose your body to the sun?

More than 3 months ago

2-3 months ago

1-2 months ago

Less than a month ago

Less than 2 weeks ago

When tanning, how often do you expose your entire body?

Never Hardly ever Sometimes Often Always

TOTAL:_________________

Skin Type Total: _____________________

THIS RECORD MUST BE KEPT ON FILE IN THE SALON FOR EACH TANNING CUSTOMER

Skin Type Score Skin Type Number 0-7 1 (You may not tan) 8-16 2 17-25 3 25-30 4 Over 30 5-6

Reaction to Sun Exposure

What happens when you stay in the sun too long?

Painful Redness, Blistering,

Peeling

Blistering followed by

peeling

Burn sometimes followed by

peeling

Rarely Burns Never Burns

To what degree do you turn brown?

Hardly or Not At All

Light Color Tan

Reasonable Tan

Tan Very Easily Turn Dark Brown Quickly

How does your face react to the sun?

Very Sensitive Sensitive Normal Very Resistant Never Had a Problem

How often do you turn brown within several hours after sun

exposure?

Never Seldom Sometimes Often Always