Ureka Health-Discover Your Healthier Lifestyle

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Ureka Health-Discover Your Healthier Lifestyle

Get Personalized Skincare Product Recommendations for you based on your needs and what your friends/family are loving! This survey will help prepare our beta demo for users.

Email *

What is your age?

18-24

25-29

30s

40s

50s

60s

Clear selection

How would you describe your skin?

Dry

Oily

Combination

Balanced/Normal

Sensitive

I am not sure

Other:

Clear selection

How do you describe yourself when it comes to discovering your skincare routine? *

Do not have a skin care routine

I am starting to research

I have tried products but am not satisfied with the products I have tried

I have some products I like but interested in finding more

I am satisfied with my skincare routine

Other:

What are your personal care goals? *

Prevent wrinkles/fine lines (anti-aging)

Hydrate skin (facial)

Hydrate skin (body)

Make skin tone more even

Remove acne (facial)

Remove acne (body)

Protect against sun

Remove dark spots

Reduce facial pores

I am not sure

Other:

Required

We want to get to know you! The next few questions dive into your skin care routine. Whether you use just facial soap or have a 9-step routine, we want to hear from you!

What is your first step in your morning skincare routine?

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms