Skincare Survey

How does skincare prevent wrinkles?

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This assessment helps me to understand & evaluate your individual skincare needs.

Thanks for taking the time to share your answers. I'll get back to you within 24-hours with an email or a text. Julia Nix

Skincare Survey

First

Middle

Last

Phone

Address (fill out if you want samples mailed to you)

Street Address

Address Line 2

City

State / Province

ZIP / Postal Code

What’s your Shaklee status?

I love Shaklee & I use many products.

I’ve never tried Shaklee before.

I want to introduce Shaklee to my friends in an online or in-person educational setting.

I want to see if I qualify to be a Brand Ambassador.

How old are you?

Under 30

30 – 49

50+

Which of the following best describes your skin type?

Oily: Your skin tends to be shiny and may be prone to acne or blackheads.

Dry: Your skin often feels tight, flaky, or rough.

Combination: You experience a mix of both oily and dry areas on your face.

Normal: Your skin is balanced, not too oily nor too dry.

Sensitive: Your skin is prone to redness, irritation, or allergic reactions.

What’s your primary skin concern?

Active Acne

Dryness

Fine Lines & Wrinkles

Uneven Skin Tone

No Major Concerns – Interested in Safer Products

What’s your secondary skin concern?

Dullness

Large Pores

Fine Lines & Wrinkles

Redness

Skin Spots & Discoloration

No Major Concerns

What’s Your Relationship with Skincare?

Skincare is everything to me, day & night.

I have a decent multi-step routine.

I only use face wash & moisturizer.

What? I should wash my face with something other than the soap in the shower?

Please list any other concerns or questions you might have here. Happy to help!

(352)223-5115

[email protected]

This site was created by Julia Nix, Independent Consultant with Beautycounter. Beautycounter has no connection with this site and does not sponsor or support its content.