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Beautycounter Sample Request Form
Interested in Beautycounter but want to try the products out first? Use the questions below to help me determine which products may be best for your needs! Can't wait to share better beauty with you!
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Email
*
Your email
Full Name
*
Your answer
Mailing Address
*
Your answer
Select 2-3 samples you would like to try
Countercontrol Sampler Pack (Oily + Acne Prone line)
Countermatch Sampler Pack (Optimal Hydration line)
Countertime Sampler Pack (Anti-Aging line)
Reflect Effect AHA Smoothing Facial Mask
Reflect Effect Overnight Resurfacing Peel
Charcoal Facial Mask
All Bright C Serum
Skin Twin Featherweight Foundation
Are you a current client of mine?
Yes
No
Clear selection
Have you used Beautycounter products before?
Yes
No
Clear selection
Are you interested in earning Free and 50% Off Products by hosting a virtual or in person event? (My average host earns 2 Free Product and 3 Half Off.)
Yes!! Tell me more
Maybe, I'd like to hear more about what it entails
Not at this time
Clear selection
Have you ever considered joining Beautycounter as a Brand Advocate?
Yes - I'd love to hear more
No, thank you
Maybe - Can you share more information with me?
No, but I know someone who would be amazing!
Clear selection
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