Your answers and photos go directly to Niya (BSN, RN). Once you submit, you'll be taken to secure checkout to complete payment. Your custom plan will be in your inbox within 48 hours of payment.
So Niya knows where to send your plan.
Helps Niya tailor your plan to your skin's stage of life.
Because the person being reviewed is a minor, we need verifiable consent from a parent or legal guardian before we can deliver a plan. Don't worry — this just takes a few extra steps. You can complete the rest of this form, but the plan won't be issued until consent and ID are verified by Niya.
Required for anyone under 18. All three steps below must be completed.
Print, sign, and either scan or photograph the completed form.
The adult who is signing the form on the minor's behalf.
Two files required: the signed consent form (PDF or photo) and a clear photo of the parent's government-issued photo ID (driver's license, passport, or state ID).
Check all that apply. Niya will prioritize the ones you flag as most important.
Be honest. There are no wrong answers — this just helps Niya avoid double-recommending things you already use.
Required so Niya can flag any safety concerns. Your information stays private.
Upload 1-3 clear photos of the area you want reviewed. These go directly to Niya.
Before submitting, please confirm each of these about your photo(s). This ensures Niya can give you the best review on the first try.
Optional. Tell Niya anything you want her to know about your skin, your goals, or your lifestyle.
