Skincare Consultation Questionnaire with Jessica Espinoza
After you answer these questions I will be able to provide you with personalized product recommendations that fit your skin's unique needs and your budget. You can expect a reply from me within 24-48 hours (excluding weekends and holidays).

If you would like recommendations for yourself AND someone else (spouse, teenager, etc.) please fill out the form for each person.

FIRST THINGS FIRST, I need to know who you are and how to contact you :-)

Email address *
Your answer
Name *
Your answer
SKINCARE
NOTE: Even if you are only interested in cosmetics, I still need to know about your skin type
Which of these best describes your skin type? *
What does your current skincare routine look like? Tell me which products you use and how you use them (i.e. AM and PM, what order do you apply the products?)
Your answer
What is your preferred skincare budget? *
Cosmetics
Would you also like safe cosmetics recommendations? *
If you answered yes to cosmetics, please tell me the specific products (including brands and colors) you currently use.
Your answer
Which of the following do you use when you wear makeup? Check all that apply.
Which colors do you like to use?
What is your preferred cosmetics budget? *
Haircare
Would you also like safe hair care recommendations? *
If you answered yes, please tell me more about your hair type (i.e dry, damaged, oily, normal, straight, wavy, curly, kinky).
Your answer
If you answered yes, please tell me about your current hair care routine, including any styling products, and how often you use each product.
Your answer
Last Questions!
Would you like more information about Band of Beauty which earns you 15% product credit on every order, free shipping on orders over $100, and a gift at sign up? *
Anything else you want me to know? Do you want to give me more details about anything? Tell me here!
Your answer
Last question: are you interested in getting more information about becoming a Beautycounter consultant? *
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service