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Spa Beauty Session
Tell me more about you - if you could change one thing about your skin what would it be?
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* Indicates required question
Are you currently using a skin care program?
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Yes
No
What kind of skin do you have?
*
Normal / Dry
Combination / Oily
What are the things you want to change about your skin? Please pick up to 5
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Add Moisture
Reduce Blackheads/Acne
Make Pores appear smaller
Increase the softness and smoothness of my skin
Acne Prone Skin (Consistant Acne)
Even out my skin tone/ dark spots
Tired and puffy eyes
Dry Body Skin
Advanced signs of Aging- Deep lines and wrinkles
Moderate signs of Aging- Fine lines and wrinkles
Fine Lines around the eyes
Dry Chapped Lips
Dry Hands or Feet
Past Damage to my face (Please only check this if you can use retinol)
Required
Your name (First and Last please)
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Your answer
CellPhone number.
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Your answer
Email Address
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Your answer
How do you prefer communication? (check all that apply)
*
Call
Text
Add me to email list
Required
Age Range
under 18
20-30's
30-40's
50+
If I sent you samples based on what you marked on this survey with video links explaining how to use them, would you try them and let me followup with you to get your feedback?
Your answer
If you marked yes, please include your full address with city, state and zip code. Thank you!
Your answer
If you have any questions, please contact Erin Steinle (952)204-5685. www.marykay.com/erinsteinle
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