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!

Manager, Beautycounter
Founder, Nutrition Nut on the Run

Email address *
Full Name *
Your answer
May I email you about safer skincare education, new Beautycounter product launches, and special deals?
How old are you? *
Select the best option that best describes your skin type. *
Please select the concerns that apply to you and that you’d like to address. *
Have you had a reaction to skincare or makeup products in the past? If so, please indicate which products caused this type of reaction and the symptoms you experienced. *
Your answer
What does your current skincare routine consist of? Please list in order of application, the brand name and product name. *
Your answer
What do you like about your current skincare routine? What don’t you like about it? *
Your answer
Are you interested in Beautycounter's makeup and receiving product recommendations? *
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
Do you have a budget in mind? If so, what range would you like to stay in to get started? *
Are you interested in learning about the men's skincare line, Counterman?
Are you interested in learning about starting a side business with Beautycounter?
Do you have any additional comments, concerns or questions relating to your skincare or makeup needs? *
Your answer
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