Clean Skincare & Beauty Questionnaire
Hi friends! I know switching to cleaner & safer products can be overwhelming, but I am here to help!

I'll also add you to my Clean Beauty email list where you'll get insider tips, tricks and early access to specials and promotions (no spam, I promise!). Helping people is my passion and my goal is to educate and empower you to find better, cleaner options that work for your skin and your life.
Email address *
Name
Your answer
Age (This helps me find the right products for you)
Your answer
Are you interest in a "Cleaner Living" Consultation?
I have different types of consultations that can help you make the switch to safer products! I do all the work and you just tell me what your "clean" goals are!
What are your current skincare goals? Any issues you're currently having that you want to fix?
Your answer
What are your current skin concerns?
After you wash your face, what happens?
If you've ever had a reaction to a skincare product, what was it and how did you react?
Your answer
What does your current skincare routine look like? Are you happy with it? What are you looking to switch out?
Your answer
Would you like recommendations for make up? If so, please list what you're looking for (and what you're currently using!) | Please be specific!
For example, if you're looking for foundation, indicate what kind, what type of coverage, etc.!
Your answer
Are you interested in becoming a Beautycounter consultant? If so, I'm happy to share more info!
No pressure AT ALL to join but I'm happy to send over more information! BC consultants get a 25% discount off of all products, 25%-35% commission on any products sold and there are never any spending requirements, order requirements, or anything like that :)
Please share any other questions or concerns you might have! Ask anything and everything and I'll do the best I can to help you.
Your answer
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