Sensitivity

Allergy feedback

Nature of Enquiry

Region

Platform purchased

Product Name

Date of Purchase

Location of the reaction

Appearance of reaction

Feel of reaction

Age Range

Gender

Batch Number（5 digits at the bottom of the product）

How long had you been using the product before you experienced the reaction?

How long after stopping use of the product did your symptoms persist?

Are you allergic to any ingredients or products? If so, what?

Were you using any other new product in conjunction with the Ego product? Yes No

Was a doctor consulted about the reaction? Yes No

Was any treatment required for relief of the symptoms? Yes No

Do you have any skin conditions/sensitive skin? Yes No

Last Name*

First Name*

Email Address*

Contact Number

Additional Information