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Online Consultation

Amy, Amy Geoghegan, along came amy, skin care

Inspired to start really caring for your skin? Great! No matter if it’s 1:00 am or you’re over the other side of the country, I’ve made it easy for you to make a start right now. Simply answer the questionnaire below and unashamedly upload some selfies. I will review your response and come back to you with skin insights, treatment prescriptions and product prescriptions.

All my prescriptions and recommendations are based on research and experience, not endorsements or funding, so you can be sure you’re getting 100% truth and skin goodness.

Please fill in everything you can to help me best understand your goal from our meeting.

Full Name *

Email address*

How did you hear about me?

Friend

Instagram

Facebook

QLD Health Campaign

Online Search

Other

Date of Birth*

Gender

Male

Female

Postal Address: (city, state, postcode)

Pregnant?

Yes

Breastfeeding?

Yes

Do you smoke?

Yes

Health Conditions:

Have you ever been diagnosed with Cancer? Date of last treatment? *

Are you currently on any medications?

Yes

Prescription topicals (eg. Retinol): *

Do you have any allergies (eg. Aspirin):

Yes

If "Yes", please describe.

When was the last time you had a peel or microdermabrasion?

Are you currently with a plastic surgeon?

Yes

Do you have botox or any form of injectables?

Yes

If "Yes", please describe.

Have you had previous facial surgery?

Yes

If "Yes", please describe.

Other treatments we should be aware of?

Yes

If "Yes", please describe.

What are your top 3 main skin concerns? *

Do you have any skin conditions (eg eczema): *

What type of skin do you feel you have? (eg dry, normal, oily, combination, sensitive)

Current skincare routine (AM+PM)

Brand of each product you are currently using:

Do you drink plenty of water throughout the day? How much?

Do you eat healthily, or do you think this could be improved on?

Do you exercise regularly?

What are your expectations from this consultation? (ie product recommendation)*

Please Upload 3 x photo’s concentrating on problematic area of concern.

Upload

Thank you for taking the time to fill out these questions. You will hear from me soon.

Skin Trust. Skin Passion. Skin Online Consults.

An Along came Amy consultation is all about honesty. Amy herself believes that home care is a lot more important than having treatments on a regular basis. She believes if you are given the correct skincare routine and information with the right ingredients in your products your skin will function at its optimal level. Less is more.
Let’s get your skin health back!

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