Sample request form

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

Sample request form

I am so excited to introduce you to L'BRI If you'd be willing and enjoy trying samples of L'BRI's Aloe-Vera based skin care, body care or hair care, simply fill this out and I will be in contact with you to personalize samples based on your request. I hope you enjoy L'BRI as much as I and so many other women and their families do! ~Jennifer Scheidt, your Independent L'BRI Skin Care Consultant https://linktr.ee/Jenniferscheidt

First & Last Name (if your FB name is different please include both) *

Street Address *

City, State, Zip *

County *

Best way to reach you? *

Phone Call

Text

Facebook Messenger

Required

Email address *

Phone # *

If not okay to text, please include that.

How familiar are you with L'BRI PURE n' NATURAL skin care? *

Never heard of L'BRI

Heard of L'BRI, but have never tried the skincare for my face

Just getting started - using it less than 2 months

Using L'BRI less than 1 year

Using L'BRI more than 1 year

Let's identify your Skin Type *

To get the best results from our skin care products, it's important to first identify your skin type.

T-Zone oiliness (forehead, nose and chin) with dry areas

Normal to Oily skin with occasional blemishes

Very oily skin

Frequent Blemishes

My skin is normal to dry and is sometimes sensitive.

My skin feels tight, very dry, with flakiness or matte finish.

I typically use an oil-free moisturizer

I already use L'BRI and love my TRIO

I have been using L'BRI and need to make a change in my TRIO

I would like to try the Body and/or Hair Products instead

I have Eczema

I have Psoriasis

I have curly, oily, dry or frizzy hair and would love the hair samples

Other:

Required

Any other skin concerns or challenges for you or someone in your family that you'd like me to help with?

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