1. Beautycounter only currently ships within the U.S. and Canada. Could you confirm that you live in either country?
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2. What's your full name (first and last)? *
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3. Have you ever tried any products from Beautycounter before? *
4. If so, which products have you tried? How did you like them?
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5. Select the best option to describe your skin. *
6. Do you have any of the following concerns? Check as many as apply to you. *
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7. If you've had a reaction to skincare products in the past, please tell me more about which product(s) you reacted to and what type of symptoms you experienced.
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8. What does your current skincare routine consist of? Please include the following information: Product and brand name, time of day used (i.e. morning or night), and then list products in order of application. *
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9. Do you have a budget in mind? If so, what range would you like to stay in to get started?
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10. Are you interested in hearing about our makeup products and receiving recommendations?
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11. If you are interested in cosmetics, please tell me a little bit about which products you currently use and would be interested in replacing with safer options.
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12. Please list any other concerns or questions you might have here. I am happy to support you any way that I can. Thank you!
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13. Are you interested in learning about becoming a Beautycounter consultant or hosting a social to get free products? *