Anna's Skincare Survey
Thanks for stopping by! Please take this survey to give me a sense for what your skin is like (what issues you're dealing with, what your biggest concerns are, what you love about your skin, etc.) to help me make great safe skincare recommendations for you:
* Required
Email address
*
Your email
Phone Number
Your answer
Instagram Handle
Your answer
What's the best way for me to contact you?
Email
Text
Instagram Message
Other:
Clear selection
Your First Name:
*
Your answer
Your Last Name:
*
Your answer
Please share your birthday so I can add you to my Birthday Club! (You get $10 back from me on a purchase made in your birth month. Yay!)
Your answer
Your Age:
*
Under 18
18-24
25-30
31-35
36-45
46+
How would you describe your skin type?:
*
Normal (no or few blemishes, balanced, etc.)
Oily (dull or shiny complexion, blackheads and breakouts more common, large pores common)
Dry (dull or rough complexion, irritation common, flaky)
Combination (areas of both dry and oily skin usually along the forehead, nose, and chin)
Sensitive (does not tolerate many products well , redness, irritation, itchy, burning common)
Do you have any of the following skin concerns? Select all that apply:
*
active acne
acne scars from historic acne
dryness
dullness
general overproduction of oil
fine lines/wrinkles
aging skin
skin spots/discoloration
ezcema or dermatitis
a known reaction to skincare products
redness or uneven skin tone
large pores
other
Required
If you have had a reaction to skincare products before, please tell me more about what products and what symptoms you exhibited:
Your answer
What does your current skincare routine consist of? (Please list when you use them, i.e. morning or night, the order of application, and the brand/company.):
*
Your answer
Do you have a budget in mind? If so, what range would you like to stay in to get started?
*
less than $50
$51-$100
$101-$150
$151+
I'm open, depending on what's needed
Are you interested in hearing about our makeup line and recommendations on products?:
*
yes
no, not right now
If interested in cosmetics, 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 other concerns or questions you might have here. I'm happy to help as much as I can!:
Your answer
Are you interested in learning more about becoming a Beautycounter consultant?
Yes, I'd love to get more details.
Maybe...!
No, I'm not interested in that opportunity right now.
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Send me a copy of my responses.
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