Skincare + Makeup Consultation Questionnaire
Finding the right products for your skin can be tricky. Let me help you take the guesswork out of it.
Please answer the following questions to the best of your ability so I can send you personalized recommendations for Beautycounter products that are free of potentially harmful ingredients.

Beautycounter is a disruptive beauty brand that not only offers safer personal care products, but is meeting with Congress about the dangers of mainstream cosmetics. We are making moves to change regulations for the entire industry with the goal of getting safer products into the hands of everyone.

Switching to safer products doesn’t have to be overwhelming, or cost a fortune! Together, we will find what works best for your skin type and budget.

Thank you for taking the time to complete this questionnaire. I would love to help you make the switch to safer skincare enjoyable and rewarding!

Cheers to safer skincare,

Senior Consultant, Beautycounter
Founder, Nutrition Nut on the Run

Email address *
Your Name *
Your answer
How old are you? *
What would you consider to be your skin type? *
Do you have any of the following skin concerns? *
If you have had a reaction to skin care products before, please tell me more about the products and what symptoms you exhibited. *
Your answer
What does your current skincare routine consist of? Please list the products/brand, when you use them (i.e. morning or night), and the order of application. *
Your answer
Do you have a budget in mind? If so, what range would you like to stay in to get started? *
Are you interested in hearing about Beautycounter's makeup line and receiving recommendations on products? *
If interested in makeup, please tell me a little bit about which products you currently use and would be interested in replacing with safer alternatives. *
Your answer
Please list any other concerns or questions you might have here. Happy to help as much as I can! *
Your answer
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