Clean Skin Care Questionnaire
Ready for a clean skin care routine?! Fill out this quick questionnaire & I'll get back to you with Beautycounter recommendations specific to your skin type!

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Email *
1. Your name. *
2. How old are you? *
How would you describe your skin type? *
4A. What is your primary skin concern? *
4B. What are your secondary skin concerns? (check top 3 concerns) *
5. If you have had a reaction to any skin care products before, please tell me more about what products and what happened.
6. What does your current skincare routine consist of? (Please list the brand/company and what you like / dislike) *
7. Do you have a budget in mind? If so, what range would you like to stay within to get started? *
8. Are you interested in hearing about our makeup line & recommendations on products? *
9. If interested in cosmetics, please tell me a little bit about which products you currently use & would be interested in replacing with safer options. *
10. Are you interested in the consultant aspect of Beautycounter? *
Please list any other concerns or questions you might have here. Happy to help! :)
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