Skincare Routine Consultation

Thank you for scheduling a skincare consultation with me!

Please complete this form ahead of our session so I can come prepared with recommendations that fit your lifestyle, budget, and the vision you have for your skin. 

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Client Information
This helps me personalize your recommendations, from climate-appropriate products to the best way to stay in touch.
What name would you like me to use? *
What are your pronouns? *
When is your birthday? *
This helps me get a sense of your age and astrological sign—both may influence product recommendations!
MM
/
DD
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YYYY
Zip Code *
Email Address *
Phone Number *
Medical Information

Everybody is different. Your answers will give me helpful context so I can offer suggestions that feel supportive and aligned with your personal rhythm.

Are you allergic or sensitive to any specific ingredients or products? If yes, please add more details. If no, write N/A. *
Are you pregnant or nursing? *
If you have any other medical considerations, please add information about those here. 
Skin Concerns + Goals
Please help me understand what you'd most like to get out of your skincare ritual + where you'd love to see improvements, shifts, or support. 
What are you most looking to get out of your consultation? *
My skin leans more... *
I want to focus on... *
Required
How often do you experience breakouts or blemishes? *
Current Routine
Let’s start with where you are now! Knowing what you’re already using—and how often—gives me a better understanding of what’s working and what's not. 
What is your current morning skincare routine? Please include steps, products, and how often you do them. *
What is your current nighttime skincare routine? Please include steps, products, and how often you do them. *
How often do you wear makeup? *
Do you wear sunscreen daily? *
Dream Routine
This section helps me understand what your ideal skincare experience looks like, from your budget to how much time you'd like to spend. My goal is to meet you where you are and make your routine feel both accessible and sustainable.
What is your ideal annual budget for skincare rituals? *
Morning Routine Time Commitment *
Nighttime Routine Time Commitment *
Skincare Values
We all have different values when shopping. I’d love to know what matters to you most so I can prioritize that in your recommendations.
How important are the following values when choosing skincare products? *
Very important
2
3
4
Not important
Pricing
Woman-owned
Brand transparency
Ingredient transparency
Fragrance-free
BIPOC-owned
Clinical testing
Sustainability
Brand loyalty
Cruelty-free
Please list any other values that are important to you here.
Where do you prefer to shop for beauty products? *
Do you have a preferred retailer? If so, please add here. 
Past Treatments/Products/Brands
This section helps me understand what your skin has already experienced, what you’ve enjoyed, and what you might want to explore (or avoid). Certain treatments can interact with active ingredients, so this helps me offer thoughtful suggestions that won't disrupt your current flow. 
I've tried and/or am interested in... *
Required
What skincare products and brands have you loved? *
Are there any products or brands that haven’t worked well for you? (Feel free to say why!) *
Is there anything else you'd like me to know?
Whew—all done! 
Thanks so much for sharing your info and goals with me. I'll review your responses to build a thoughtful, personalized routine that fits you. 

I look forward to working together! 
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