Professional Skin Care Product Evaluation and Consultation Service form 

To schedule your consultation, please fill out our easy-to-use form, providing your full name, email address, phone number, location (considering weather/climate concerns), and any additional information you would like us to know. You will also have the option to join our email list for valuable skincare tips and updates.

In the form, kindly provide the names and details of the skincare products you would like us to evaluate. If available, you can also upload pictures of the product bottles for a more accurate assessment.

Payment can be made conveniently through PayPal (via PayPal.me), Venmo, or Cash App (via phone using a credit card). Once you submit the form, Mayumi will be in touch within 24 hours to discuss the consultation process, provide payment details, and schedule an appointment either in person or via a Zoom meeting.

Thank you for choosing this services, and I look forward to assisting you in achieving your skincare goals.

Mayumi Pachkoski

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1: Full Name *
2: Email address  *
3: Phone number *
4: Location (Weather/Climate Concern): *
5: Would you like to be added to my email list for skincare tips and updates? [Yes/No] *
6: What is your current skin care concern? How do you feel about your skin? (Please provide details, such as dryness, sensitivity, breakouts, etc.) *
7: Please provide the following details for each skincare product you would like to evaluate: 
Please add each  product name and company name below.
*
8:Payment Options (Select one): *
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