Skincare Wellness Survey – Clean, Simple & Growing in Contentment with Julia Nix

Welcome to the Clean & Simple Wellness Survey!

This quick survey is for you—to help you feel better in your skin, your energy, and your daily rhythm.

Answer what applies, and I’ll share simple, personalized tips that support the season you’re in.

Let’s start with what matters to you!

Short: Clean & Simple Wellness Survey (#21)

First

Last

Email

Phone

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

Street Address

Address Line 2

City

State / Province

ZIP / Postal Code

Where are you feeling the most stuck right now?

Low energy

Trouble sleeping

Digestion issues

Weight that won’t budge

Skin that’s changing (dryness, wrinkles, breakouts)

What’s been hard about your current routine? 

Too many products

Not sure what’s working

I don’t have a routine

I forget or skip things

It’s expensive or overwhelming

How does your skin feel lately?

Dry or tight

Dull or uneven

Fine lines showing up

Pretty good-just want to keep it that way

Is your home as “clean” as you want it to be?

Not really—I’m still using harsh stuff

I try to avoid toxins, but it’s confusing

I’d love safer options that actually work

Honestly… I’m in my 60s and hate cleaning 🙃

Or maybe I’m just too blind to see the dirt—blessing or curse? 😂

What would you love more of in this season?

Energy to enjoy grandkids or travel

Confidence in my skin + wellness

A simpler routine I can actually stick to

More contentment—maybe even time for Scripture memory

Anything else you’d like to share? Questions, thoughts, or even just a hello—I read every response and love hearing from you!