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Cosmetologist

Fitzpatrick Skin Type Form

We’re here to help you on your journey to looking and feeling your best. Please fill out the form before your Initial Assessment Session.

Fitzpatrick Skin Type Form

Help Us Treat You the Right Way.....


Skin type is often categorized according to the Fitzpatrick Skin Type Scale which ranges from very fair (skin type I) to very dark (skin type VI). Genetic disposition, individual reaction to sun exposure and tanning habits are considered. Please mark the Score (0‐4) and then add the scores on the right side of the page.

Client Information

Genetic Disposition

What is the color of your eyes?
0 –Light blue\Gray\Green
1 – Blue\Gray\Green
2 – Blue
3 – Dark Brown
4 – Brownish Black
What is the natural color of your hair?
0 – Sandy Red
1 – Blonde
2 – Auburn/ light Blonde
3 – Dark Brown
4 – Black
What is the color of your skin (non‐exposed areas)?
0 – Reddish
1 – Very Pale
2 – Pale w/Beige Tint
3 – Light Brown
4 – Dark Brown
Do you have freckles on unexposed skin?
0 – Many
1 – Several
2 – Few
3 – Incidental
4 – None

Reaction to Sun Exposure

What happens when you stay too long in the sun?
0 – Painful redness, blistering, peeling
1 – Moderate redness, blistering followed by peeling
2 – Mild burn sometimes followed by peeling
3 – Rare Burns
4 – Never had burns
To what degree do you turn brown?
0 – Never
1 – Light color tan
2 – Reasonable tan
3 – Tan easy
4 – Tans darkly quickly
Do you turn brown within several hours after sun exposure?
0 – Never
1 – Seldom
2 – Sometimes
3 – Often
4 – Always
How does your face react to the sun?
0 – Sensitive
1 – Seldom
2 – Sometimes
3 – Normal
4 – Resistant

Tanning Habits

How many months ago was your body last exposed to sun, tanning light or tanning cream?
0 – More than three months
1 – Two-three months
2 – One-two months
3 – Less than a month
4 – Two weeks
Has the area to be treated ever been exposed to the sun?
0 – Never
1 – Seldom
2 – Sometimes
3 – Often
4 – Always

Skin type score 0 to 7 = Fitzpatrick Skin Type I

Skin type score 8 to 16 = Fitzpatrick Skin Type II

Skin type score 17 to 25 = Fitzpatrick Skin Type III

Skin type score 25 to 30 = Fitzpatrick Skin Type IV

Skin type score over 30 = Fitzpatrick Skin Type V-VI

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