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Email address?
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What is your first and last name?
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Instagram handle
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Tell me about your skin type.
Oily
Dry
Both
Normal
Other
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What is your primary skin concern?
Acne
Discoloration
Dryness
Lines/wrinkles
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Tell me about your secondary skin concern (if applicable).
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Do you have any known skin/food allergies or sensitivities? If so, please explain below.
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How many skincare products do you use on an average day?
1-2, fairly minimalistic
3-4, streamlined and specific
5+, skincare enthusiast
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What is the best way to connect with you?
Instagram message
Email
Text (please provide number in a direct message)
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Please write anything else you would like to share.
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