Thank you so much for your Environ order. Before we can release your order, we ask that you to complete this Environ screening form below. This is now a requirement by Environ for all Environ products sold online.

If you are ordering these Environ products as a gift please click here.

If you have previously completed this form - and within the last three months - please skip this step and instead just forward your Millies order number which starts with #M to skincare@millies.ie and we can review it and have your order released.

Please note that the sooner we receive your completed form or order number, the quicker the dispatch of your order can be.

Thank you so much in advance!

Name *

Email *

Phone *

Date of Birth *

This is not used for marketing purposes, this is only used to ensure that products purchased are suitable for your age range.

Your Skincare

Are you using Environ Skincare? *

Yes, currently using Environ.
Yes, but I have had a break from Environ - How many months since using the Environ range? (This is especially important for step-up product such as the AVST Moisturisers, C-Quence or Retinol Serums. If you have not used the range for more than 3 months you may need to revert to lower concentration product, over 6 months you are likely to need to return to the start of the programme.)
No, I have not previously used Environ

Tell us more *

How many months since using the Environ range? (This is especially important for step-up product such as the AVST Moisturisers, C-Quence or Retinol Serums. If you have not used the range for more than 3 months you may need to revert to lower concentration product, over 6 months you are likely to need to return to the start of the programme.)

What clinic or salon have you attended for your Environ Consultation? *

Does your order contain an Environ step-up programme product? *

Yes
No

This includes Skin EssentiA AVST 1-5, Youth EssentiA 1-4+ & Youth+ Retinol Serums 1-3.

Have you purchased an Environ product this time, that you haven't used before? *

Yes
No

Your Skin Routine

Please provide specific details about your current skincare routine. Provide as much detail as possible so there is no need for a follow up call and we can release your order.

Please advise products you are using including past & present, this helps us build a better picture of your skincare and will speed up any future orders placed. *

Be sure to include Cleansers, Toners, Day & Night Creams, Serums, Masks and Spfs and the brand name of each) Any other active products in your routine

Please upload a photo here of your current skincare products.

This is essential so we can see any products that may clash with Environ active products.

Your Skin Conditions

Skin Conditions (Please tick any that apply.)

Skin Type (Please tick any that apply)

Normal Skin
Oily Skin
Combination Skin
Dry Skin
Sensitive Skin
Dull Skin

Medical Feedback

Are you currently pregnant, breastfeeding or trying to conceive? *

Yes
No

Please note the majority of Environ skincare products are considered pregnancy friendly. This excludes the Body EssentiA Tri-Complex Contouring Cream.

Do you have any medical allergies? *

Yes
No

Including oral and topical supplements

What are you allergic to? *

We will review this information and aim to authorise your order in a timely manner.

Should your consultation raise any concerns our customer care team will be in touch. We must verify your order with you within 7 days or your order will be cancelled and refunded. Please note any delivery can only be honoured once your order has been verified.

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Your Skincare

Your Skin Routine

Your Skin Conditions

Medical Feedback

Thank you so much!

Thank you so much!

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VICHY Minéral 89 Hyaluronic Acid Daily Hydrating Booster Serum 75ml Hypoallergenic, for All Skin Types

VICHY Minéral 89 Hyaluronic Acid Daily Hydrating Booster Serum 50ml Hypoallergenic for All Skin Types

VICHY Minéral 89 Hyaluronic Acid Hydration Booster 30ml

VICHY Minéral 89 72H Moisture Boosting Cream Fragrance-Free Face Moisturiser 50ml

VICHY Liftactiv 16% Pure Vitamin C Brightening Serum 20ml

VICHY Capital Soleil Velvet Finish UVA + UVB Facial Sun Protection SPF50+ 50ml

VICHY Capital Soleil Tan Illuminating Sun Protection Water Spray SPF30 200ml- All Skin Types

VICHY Minéral 89 Moisture Recovery Night Cream 50ml

VICHY Purete Thermale 3-in-1 One Step Cleanser 300ml

VICHY Liftactiv Collagen Specialist 16 Peptide Night Cream for All Skin Types 50ml

VICHY Deodorant 48H Intensive Anti-Perspirant Roll-On Hypoallergenic 50ml

VICHY Minéral 89 Eyes Hydrating Eye Serum with Hyaluronic Acid + Caffeine 15ml

VICHY Capital Soleil Hydrating Fresh Sun Protection Milk SPF50+ for Face & Body 300ml

VICHY 48 HR 'No Trace' Aerosol Anti-Perspirant 125ml

VICHY Capital Soleil Anti-Ageing 3-in-1 High Sun Protection for Face SPF50 50ml

VICHY Capital Soleil Cell Protect Invisible High UVA + UVB Sun Protection Spray SPF30 200ml

VICHY Capital Soleil Hydrating Fresh Sun Protection Milk SPF30 for Face & Body 300ml

VICHY Capital Soleil Hydrating Sun Protection Water Spray SPF50 with Hyaluronic Acid 200ml

VICHY Capital Soleil Invisible Hydrating Dry Touch SPF50 Mist 200ml

VICHY Deodorant 48H No Trace Anti-Perspirant Roll-On 50ml

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