Safer Skin Care Consultation Form
Hi lovely!
It's time to clean up that beauty routine!

You do not have to sacrifice your health in the name of beauty. Beautycounter creates safer, high performance products that are not only chic on your counter, but improve your skin and provide a look that will help you feel confident and beautiful every day.

I'm so excited to help you design a routine and plan you love!

After completing the form, you will be emailed with product recommendations. If you'd like to schedule a FREE 30 minute skin care chat we can do that too.

-Danielle <3
Email address *
Name (First & Last) *
Your answer
Shipping address *
Your answer
Age
YOUR SKIN
What would you consider your skin type? *
Do you have any of the following skin concerns? (Check all that apply) *
Required
If you selected acne, please provide more details (pimples/white heads or cysts; frequency of breakouts; typical healing time; location on face; hormone related; etc.)
Your answer
SKINCARE
What are your skin care routine preferences? *
Please describe your current MORNING skin care routine. Please Include order of application and brands of products. *
Your answer
Please describe your current EVENING skin care routine. Please Include order of application and brands of products. *
Your answer
What products are you currently looking to replace and/or add to your skincare routine?
Your answer
COSMETICS
Are you interested in our cosmetics and recommendations? *
What products are you currently looking to replace and/or add to your cosmetic routine? Feel free to share current cosmetic products and brands.
Your answer
FINAL DETAILS
Do you have a budget in mind? If so, which range would feel most comfortable? (Keep in mind, I will provide you ALL the recommendations I think your skin needs - possibly for future orders, but I will star top suggestions based on your budget.) *
Include any other skin details here:
Your answer
Let's connect more! Tell me something special about you... where you live, what your hobbies are, what you are passionate about, how did we connect... whatever you'd like to share!
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy