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Reactie op blootstelling aan de zon:
Score 0 1 2 3 4
Wat gebeurt er als u
telang in de zon blijft?
Pijnlijke
roodheid,
blaarvorming,
vervellen
Blaarvor ming,
gevolgd door
vervellen
Verbrandt
soms, gevolgd
door vervellen
Verbrandt
zelden
Verbrandt
nooit
In welke mate wordt u
bruin?
Niet of
nauwelijks
Een beetje
bruin
Redelijk bruin Heel gemakkelijk
bruin
Snel
diepbruin
Wordt u al bruin na
enkele uren nadat u in
de zon bent geweest?
Nooit Zelden Soms Vaak Altijd
Hoe reageert uw
gezicht op de zon?
Erg gevoelig Gevoelig Normaal Kanergoed
tegen
Nooit last
gehad
Totaalscore voor reactie op blootstelling aan de zon :----
Erfelijke aanleg:
Score 0 1 2 3 4
Wat is de kleur van uw ogen? Lichtblauw,
grijs of groen
Blauw, grijs
of groen
Blauw Donkerbruin Bruinzwart
Wat is de natuurlijke kleur
van uw haar?
Zandrood Blond Kastanje/
donkerblond
Donkerbruin Zwart
Wat is de kleur van uw huid
(bedekte delen)?
Rossig Heel blank Blank met
beige teint
Lichtbruin Donkerbruin
Hebt u sproeten op bedekte
delen van de huid?
Veel Meerdere Weinig Een enkele Geen
Totaalscore voor erfelijke aanleg :----
18


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