Lira Clinical Order Form

Name *

First Name

Last Name

Phone *

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Skin Type

Oily

Dry

Combination

Normal

Sensitive

Unsure

Skin Concerns

Acne

Pigmentation

Dry/dehydrated

Ageing

Rosacea

Congestion

Reactive Skin

Dull Skin

Texture

Lira Clinical Order *

Select the products you would like to order

PRO Exfoliating Cleanser ($89)

PRO Lite Serum ($129)

PRO Firming Serum ($179)

PRO Retinol Creme ($189)

PRO Lux Lash ($159)

PRO Anti-Ageing Pads ($119)

PRO Retinol-Plus Treatment ($320)

PRO Brightening Masque ($115)

PRO Brite-Plus Serum ($139)

BIO Enzyme Cleanser ($89)

BIO Hydra C Serum ($159)

BIO Hydra Infusion ($125)

BIO Lift Creme ($179)

BIO Caviar Creme ($179)

BIO Hydrating Mineral Masque ($99)

BIO Lip Factor ($50)

MYSTYIQ iLuminating Cleanser ($89)

MYSTYIQ Intense C15 Booster ($189)

MYSTIQ Perfecting Eye Creme ($139)

MYSTIQ iLuminating Polisher ($95)

MYSTYIQ Lifting Masque ($95)

MYSTYIQ iLuminating Beauty Oil ($149)

MYSTYIQ Infused C CBD ($359)

ICE Sal Cleanser ($92.50)

ICE Balancing Lotion ($92.50)

ICE Clarifying Treatment ($92.50)

ICE Clarifying Scrub ($92.50)

ICE Refining Masque ($92.50)

ICE Clear Stick Acne Spot Treatment ($62.50)

SPF Solar Shield 30 Oil Free ($90)

SPF Solar Shield 30 Classic Tint ($90)

SPF ElioDrops 30 Glow ($125)

SPF ElioDrops 30 Sheer ($125)

Shipping

In-store Pick Up

NZ Shipping $6