0
|
1
|
2
|
3
|
4
|
Score
|
|
What
is the color of your eyes?
|
Light Blue, Grey or Green
|
Blue, Grey or Green
|
Blue
|
Dark Brown
|
Brownish Black
|
|
What
is the natural color of your hair?
|
Sandy Red
|
Blonde
|
Chestnut, Dark Blonde
|
Dark Brown
|
Black
|
|
What
is the color of your skin? (unexposed)
|
Reddish
|
Very pale
|
Pale with beige tint
|
Light Brown
|
Dark Brown
|
|
Do
you have freckles on sun-exposed areas?
|
Many
|
Several
|
Few
|
Incidental
|
None
|
|
What
happens when you stay in the sun too long?
|
Painful redness, blistering, peeling
|
Blistering followed by peeling
|
Burns, sometimes followed by peeling
|
Rarely burns
|
Never had burns
|
|
To
what degree do you turn brown?
|
Hardly or not at all
|
Light color tan
|
Reasonable tan
|
Tan very easily
|
Turn dark brown quickly
|
|
Do
you turn brown several hours after sun exposure?
|
Never
|
Seldom
|
Sometimes
|
Often
|
Always
|
|
How
does your face respond to the sun?
|
Very sensitive
|
Sensitive
|
Normal
|
Very resistant
|
Never had a problem
|
|
When
did you last expose yourself to the sun or tanning beds?
|
More than 3 months ago
|
2-3 months ago
|
1-2 months ago
|
Less than 1 month ago
|
Less than 2 weeks ago
|
|
Do
you expose the area to be treated to the sun?
|
Never
|
Hardly Ever
|
Sometimes
|
Often
|
Always
|
Total _______
Fitzpatrick Skin Type
I
(0-7)
II (8-16) III (17-25) IV
(25-30) V-VI (over 30)
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