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Skincare + Makeup Questionnaire
Fill out this quick questionnaire and I'll get back to you ASAP with recommendations specific to your skin type, skin needs, and make-up look!
In health!
Courtney
www.courtneydonmoyer.com
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Email
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Your email
Today's Date
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MM
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DD
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YYYY
Full Name
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Your answer
Age
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Your answer
What would you consider to be your skin type?
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Normal (no or few blemishes, balanced, not dry or oil)
Oily (dull or shiny complexion, blackheads, clogged pores, usually breakouts somewhere on the face, large pores)
Dry (dull or rough, irritation, redness, flaky, acne from dry skin-buildup)
Combination (areas of both dry and oily skin, an oily T-Zone)
Sensitive (does not tolerate many products well, redness, irritation, itchy, burning)
Other:
Whats your primary skin concern?
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Dealing with active acne and/or acne scarring
Dryness
Aging Skin (wrinkles, brown spots)
No major concerns, just making the switch to non-toxic skincare
Other:
What are your secondary skin concerns?
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Dullness
Large Pores
Redness
Brown Spots/Melasma
Fine Lines, Wrinkles
Acne Scarring
Eczema
Active Acne
Other:
Have you ever had a reaction to skin care products before? Please describe the product:
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Your answer
What does your skincare routine look like now? Please describe brands you like/use:
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Your answer
Do you have a budget in mind? If so, what range would like you like to stay in?
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Less than $50
$50-$100
$100-$150
$200 or more
I'm open - depending on what I need.
What make-up products do you use now?
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Your answer
List your must-haves when it comes to your daily makeup-routine:
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Undereyes (concealer for brightening/lightening)
Lashes (lengthening, volumizing)
Full Coverage Foundation (concealing brown spots, acne, redness)
Eyeshadow to enhance the eyes
Blush and Bronzer to add color, vibrancy and depth to the skin
Other:
Required
List your favorite make-up products now:
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Your answer
Are you interested in becoming a consultant?
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Yes! I want to learn more!
No, not right now.
Maybe, need to think about it.
Are you shopping for anyone else? Husband, children, etc?
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Your answer
Any other questions or concerns for me? Happy to help!
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Your answer
A copy of your responses will be emailed to the address you provided.
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