Volunteers of East Asian descent are needed to participate in an Asian Skincare Clinical Research Study. This questionnaire form will take less than 5 minutes to complete.

Financial compensation of $300 will be provided upon your successful completion of the study.

All information given will be kept strictly confidential and is only used within the purposes of the clinical study. Contact Ann Lee, the Clinical Manager, at (347) 879-0333 or skinlighteningstudy2013@gmail.com if you have trouble completing the online form, or if you have any questions.

* 1. Full Name

* 2. Phone Number

* 3. Email Address

* 4. What is your occupation?

* 5. Age

* 6. Gender

* 7. Are you of Eastern Asian descent (e.g. Chinese, Korean, Japanese)?

* 8. Do you have at least 5 pigmented spots (hyper-pigmentation or age spots) located on EACH side of your face?

* 9. Which of the following best describes your skin?

* 10. Do you have any disease state or physical facial skin conditions (e.g. atopic dermatitis, eczema, psoriasis, seborrheic dermatitis, acne, or rosacea) which might impair evaluations of your facial skin?

* 11. Are you under the care of a physician for any identified facial skin condition?

* 12. Do you spend large amounts of time in the sun, for recreation or for your occupation?

* 13. Do you have any known allergies or sensitivities to cosmetic products, toiletries or their ingredients?

* 14. Have you been involved in another facial skin care clinical investigation within the previous 3 months?

* 15. How did you hear about this clinical study?

* 16. Are you available for in-person appointments at the clinical site on ALL of the following days: Friday February 15th, Thursday March 14th, Thursday March 28th and Friday May 10th? Please only select "Yes" to this question if you are available on all four of these dates.

Each appointment will last for approximately 30 minutes. The clinical site is located on the Upper East Side.