Beautycounter Skincare Consultation
Skincare Questionnaire
Thank you for taking the time to fill out this questionnaire! It will help me make the best recommendations for your skin.~Melissa
First & Last Name:
Your answer
Email Address:
Your answer
What do you think your skin type is?
Do you have any of the following skin concerns? Check as many as apply:
If you had a reaction to skin care products before, please tell me more about what products and what symptoms you exhibited. Please also list any known ingredient allergies:
Your answer
What does your current skincare routine consist of? (Please list when you use them, i.e. morning or night, order of application, and the brand name)
Your answer
Do you have a budget in mind for your initial order? If so, what range would you like to stay in? (I will provide you with a few different options that will allow you to pick and choose products to stay within budget!)
Are you interested in hearing about our cosmetic line and recommendations on product?
If yes to above, please tell me a little bit about which products you currently use and would be interested in replacing with safer options:
Your answer
Please list any concerns or questions you may have here! I am happy to lend as much support as I can, and helping you find the perfect products to give you your dream-skin is my passion!
Your answer
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