Melasma Patient Form To get the most out of your visit, please complete the questions below prior to your appointment. LinkedInThis field is for validation purposes and should be left unchanged.Full Name(Required)I use sunscreen -(Required) Once a day Twice a day Occasionally Never My daily sunscreen is -(Required) Clear or white (untinted) Tinted (brown) A regular 50 ml bottle of sunscreen last around-(Required) Last 2 weeks Last 2-4 weeks Last 1-2 months Last 2-4 months Last 4 to 8 months Do you use an activity sunscreen (secondary sunscreen) for outdoor activities?(Required) Y N Occasionally Pick the best response, my sunscreen use -(Required) Religious, I use sunscreen regularly I only use sunscreen when I am outside I occasionally use sunscreen I seldom or never use sunscreen
