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Acne
Acne treatments
Anti – Age
Anti Stress
Atelocollagen
Body Care
Bust and decollate skin care
Cleansers
Cleansing
Exfoliators
Face Rejuve
Facemasks
For Men
Glow Skin
Hand Care
Hyaluron Plus
Mandelic Acid
Moisturisers
Multi Vitamin
Pearls and Gold
Peelingi
Re-Generation GF
Renew Extreme
Sensitive
Skin Care
Skin Pigmentation Correctors
Slimming cosmetics
Spongellé
Sunscreens
The problem of “heavy legs”
Toners
Whitening
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Menu
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About Us
Treatments
Laser Hair Removal
Mesotherapy
Profhilo
Dermalux Flex
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ZO Protect
zo prevent & correct
Contact Us
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Results
ZO® Skin Health Protocol: Consent Form
ZO® Skin Health Protocol: Consent Form
Zein Obagi, MD recommends using an at-home regimen of ZO® Skin Health products to maximize the benefits.
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Have you used Accutane® or any prescription retinoid products (Retin-A®, Renova®) in the last 3 months?
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Have you used products containing retinol in the past week?
Yes
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Are you allergic or sensitive to aspirin?
Yes
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Are you undergoing any type of radiation or chemotherapy?
Yes
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Do you have herpes or cold sores?
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Within the last week, have you had any facial waxing, electrolysis or used any depilatories?
Yes
No
Do you have any form of auto-immune disease (diabetes, lupus, etc.)?
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Do you have a sensitivity or allergy to : Lactic Acid:
Yes
No
Do you have a sensitivity or allergy to: Citric Acid:
Yes
No
Do you have a sensitivity or allergy to: Salicylic Acid:
Yes
No
Do you have a sensitivity or allergy to:Retinol (Vitamin A):
Yes
No
Do you have a sensitivity or allergy to: Latex:
Yes
No
Have you had facial cosmetic surgery in the last month (laser resurfacing, dermabrasion, chemical peel, face lift, blepharoplasty, Botox®, injectible fillers)?
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Have you had facial cosmetic surgery in the last month (laser resurfacing, dermabrasion, chemical peel, face lift, blepharoplasty, Botox®, injectible fillers)?
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