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The Rich Skin Club Consultation Form
Tell me about your skin, current skincare routine, concerns and goals.
* Indicates required question
Email
*
Your email
Date of birth
*
MM
/
DD
/
YYYY
What's your skin type?
*
Normal
Dry
Oily
Combination
Sensitive
Not sure
Required
If you're not sure about your skin type, tell me a bit about it...
Your answer
If you have Sensitive skin please let me know if you have any allergies to certain ingredients...
Your answer
Do you have a skin condition you struggle with? i.e. acne, eczema, or dryness.
*
Yes
No
If you answered yes to the above question, tell me a bit about your skin condition...
Your answer
Is aging/wrinkles a concern for you?
*
Yes
No
If you answered yes to the above, please elaborate a little..
Your answer
What are your biggest skin struggles?
*
Your answer
Do you have a current morning and evening skincare routine?
*
Yes
No
Other:
Please tell me all about your current morning and evening skincare routines...
*
Your answer
Please list ALL of your skincare products for me
*
Your answer
Describe your skin goals and desires. What does your ideal skin look like in 3-4 months time?
*
Your answer
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