DOSE Skin

Personalised Online Skin Consultation

At DOSE, we believe great skin starts with understanding you — not just your skin type, but your lifestyle, your goals, and your history. Take your time with this — the more detail you give me, the better I can help you.

Brittni x

Section 1 of 9
1

About You

Your personal details

1.Full Name *
Please enter your full name.
2.Date of Birth *
Please enter your date of birth.
3.Email Address *
Please enter a valid email address.
4.Phone Number *
If outside Australia, please include your international dialling code
Please enter your phone number.
5.Address *
Please enter your street address.
2

Your Skin Goals

Tell me what you're working with

6.What are your main skin concerns? *
Select all that apply
Please select at least one concern.
7.Tell me more about your skin *
How long have you been experiencing these concerns, and what does your ideal skin look like?
Please share a little about your skin.
8.What are you hoping to get from this consultation? *
Select all that apply
Please select at least one option.
8a.What type of treatments are you interested in? *
Please select an option.
8b.If a more invasive treatment would give you the results you are after, would you be open to exploring that? *
Please select an option.
3

Your Skin Profile

Your current skin & routine

9.How would you describe your skin type? *
Please select your skin type.
10.What does your current skincare routine include? *
Select all that apply
Please select at least one option.
11.Describe your current morning & evening skincare routine in detail *
Products, brands, and how often you use them
Please describe your routine.
12.Do you have any known skin allergies or sensitivities? *
Please select an option.
13.How does your skin respond to sun exposure? *
Fitzpatrick Scale
Please select an option.
14.Do you ever experience any of the following?
Select all that apply
15.Do you blush or flush easily?
16.If yes, what tends to trigger it?
Select all that apply
17.How often are you exposed to the sun or UV?
Select all that apply
18.Do you wear SPF daily? *
Please select an option.
4

Treatment & Medical History

Past treatments and health background

19.Have you previously had any of the following treatments?
Select all that apply
20.Have you ever used any of the following on your skin?
Select all that apply
21.Are you currently being treated for any skin condition? *
Please select an option.
22.If yes, please provide details
23.Any personal or family history of skin cancer? *
Please select an option.
24.Do you have any known medical conditions we should be aware of?
25.Have you ever had a reaction to any of the following?
Select all that apply
5

Injectables

Your injectable history & plans

26.Do you currently use or have you previously had injectables? *
Please select an option.
27.What type(s) of injectables have you had?
Select all that apply
28.Do you have any injectable appointments planned in the next 2–4 weeks?
29.Have you ever experienced any complications or reactions from injectables?
30.If yes, please describe
6

Hormones & Women's Health

Hormonal factors that affect your skin

31.Do any of the following apply to you?
Select all that apply
7

Internal Health & Wellness

Lifestyle factors that influence your skin

32.Are you currently taking any oral medications? *
Please select an option.
33.If yes, please list them
Including any prescribed skin medications
34.Do you take any supplements or vitamins?
35.If yes, which ones?
36.How would you describe your gut health / digestion?
37.How would you rate your stress levels? *
Please select an option.
38.How would you describe your mental health and overall wellbeing at the moment?
39.Do you sleep well? *
Please select an option.
40.Do you exercise regularly?
41.Do you follow a specific diet or have any dietary preferences?
42.How many glasses of water do you drink per day?
43.How many caffeinated drinks do you have daily?
Coffee, tea, energy drinks
44.Do you drink alcohol?
45.Do you smoke or vape?
8

Photos & Final Details

Almost there!

Skin journeys are something I genuinely love sharing at DOSE — before and after photos are one of the most powerful ways to track your progress and inspire others who might be where you are right now. Your comfort always comes first and nothing will ever be shared without your approval.
46.Do you consent to Before & After photos? *
Please select an option.
47.Please upload 3 clear photos of your face *
Natural light is best — 1 front facing, 1 each side. No makeup where possible.
📷
Tap to upload photos
JPG, PNG or HEIC accepted
Please upload at least one photo.
48.How would you prefer to be contacted? *
Please select at least one option.
9

Declaration

Last step!

49.Please confirm the following before submitting *
Please confirm both statements to continue.
Thank you so much for taking the time to fill this out — I genuinely can't wait to put together something just for you. Please allow up to 2 business days for your personalised plan to land in your inbox. I'll follow up with a call to walk you through everything.

Speak soon — Brittni x
🌸

You're all done!

Thank you so much for trusting DOSE with your skin. I've received your consultation and will review every single detail personally.

Your personalised plan will be sent to your inbox within 2 business days, followed by a call to walk you through everything.

Can't wait — Brittni x