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* 1. What is your Name and Surname?

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* 2. Which Renewal Institute branch do you visit most often?

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* 3. If you would like us to update your e-mail address on our client database, please fill in your current e-mail address below?

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* 4. Please select your gender?

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* 5. Please select your age group:

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* 6. Do you suffer from any of the below skin conditions?

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* 7. Did you know skin peels can improve all of the above conditions?

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* 8. Do you know the difference between mechanical and ingredient based exfoliation/peel treatments?

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* 9. How do you slot peels into your skin care regime?

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* 10. Do you understand peels, and its basic part/role?

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* 11. Please select which of the below is correct:

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* 12. Please select which of the below is correct:

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* 13. What, do you think, is the difference between monthly peels and aggressive peels?

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* 14. Please select which of the below Peel treatments you have had:

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* 15. Staying out of the sun after a peel is one of the most important considerations, as exposure to the sun causes pigmentation, is this True or False?

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* 16. How is skin renewed from a peel?

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* 17. How are you exfoliating your skin, at home?

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* 18. Would you like a Renewal Institute staff member to contact you to discuss the survey and & schedule an appointment?

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