Apply

Name *

First Name

Last Name

Phone *

(###)

###

####

How severe is your acne? *

Moderate (10 to 20 active acne lesions at a time)

Severe (More than 20 active acne lesions at a time)

How long have you been struggling with acne? *

Less than 1 year

A few years

Ever since I can remember

The Virtual Acne Program is designed to clear skin without the use of prescription acne medications. Are you willing to discontinue prescription acne medications, antibiotics, creams, and drugstore products before starting the program? *

Yes

No

Maybe

Lifestyle adjustments are a very important component of the Virtual Acne Program, and may include changes to your daily habits, diet, beauty products, and other areas of your life. Are you willing to make these changes in order to achieve and maintain clear skin long-term? *

Yes

No

Maybe

The Virtual Acne Program is a financial investment, but clients also need to invest their time, energy, and a positive mindset into the program for best results. Are you willing to invest in the program financially, mentally, and emotionally? *

Yes

No

Maybe

Most acne clients achieve clear skin in 4 to 6 months, but this timeline varies based on your type and severity of acne, willingness to implement lifestyle adjustments, and overall commitment to the Virtual Acne Program. Are you willing to be patient, understand that your acne may take several months to clear, and also understand that maintaining clear skin is a long-term process? *

Yes

No

Maybe