Kate's Skin & Beauty Plan Consultation

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Hi gorgeous :)

It's time to clean up that beauty routine!

You do not have to sacrifice your health in the name of beauty. Beautycounter creates safer, high performance products that are not only chic on your counter, but improve your skin and provide a look that will help you feel confident and beautiful every day.

I'm so excited to help you design a routine and plan you love!

xx, Kate

Email *

Name *

Mailing Address *

What would you consider your skin type? *

Normal (little to no blemishes, balanced, etc)

Oily (dull or shiny complexion, blackheads and/or breakouts common, large pores)

Dry (dull or rough complexion, irritation common, flaky)

Combination (areas of both dry and oily usually along forehead, nose, and/or chin)

Sensitive (does not tolerate many products well, redness, irritation, itchy, burning)

Do you have any of the following skin concerns? (Check all that apply to you.) *

Acne

Acne scars from previous acne

Aging skin

Dryness

Dullness

Eczema or dermatitis

Fine lines/wrinkles

General overproduction of oil

Known reaction to skin products

Large pores

Redness or uneven skin tone

Skin spots or discoloration

Other:

Required

SKINCARE

Describe your current MORNING skincare routine. Please include order of application and brands of products. *

Describe your current EVENING skincare routine. Please include order of application and brands of products. *

What products are you currently looking to replace and/or add to your skincare routine?

COSMETICS

Are you interested in our cosmetics and recommendations? *

Yes

Not right now.

Other:

What products are you currently looking to replace and/or add to your cosmetic routine? Feel free to share current cosmetic products and brands.

FINAL DETAILS

Do you have a budget in mind? If so, which range would feel most comfortable? (Keep in mind, I will provide you ALL the recommendations I think your skin needs - possibly for future orders, but I will star top suggestions based on your budget.) *

Less than $50

$50-100

$100-150

$200 or more

I'm open, depending on what is suggested

Include any other skin details here :)

Let's connect more! Tell me something special about you... where you live, what your hobbies are, what you are passionate about, how did we connect... whatever you want to share!

Send me a copy of my responses.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms