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Please complete the following form to start your skincare consultation with our expert skin specialists.

Once completed and you have been assessed for suitability by our expert specialists, you will receive product recommendations in an email. The Environ Skin Care products will then be unlocked and eligible to buy in our exclusive online store.

Please note, online consultations are approved Mon-Fri 9am-5pm. If completed after 3pm then you will be assessed on the next working day. Please call or email [email protected]

* = required information

About You

Contact Information

Medical History

YesNo
YesNo
YesNo
YesNo
YesNo
YesNo

Your Skin

PsoriasisEczemaRosaceaAcne
YesNo
LaserIPLPeelsMicrobdermabrasionInjectablesMicroneeding
YesNo
YesNo
Very FairFairWhiteOliveDark BrownBlack
OilyCombinationSensitiveDryNormal

Other Information

I confirm to the best of my knowledge that the answers given are correct and I have not withheld any information. I understand that results cannot be guaranteed. I will inform PleijSalon.com if any of this information changes. *

If you haven’t done so already, create a customer account at pleijsalon.com/register

Once your consultation and account have been approved, you will be able to purchase Environ Skin Care products from our online boutique at pleijsalon.com/shop. These products are medical grade and exclusively available to our approved clients.