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FREE skincare assessment and analysis.
Complete this form for a FREE skincare analysis. Results will be shared via email from
breestillings@gmail.com
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Email
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Your email
First and Last Name
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Your answer
Phone Number for texting:
Your answer
I would prefer my results from the skincare quiz be:
emailed
texted
call me on the phone
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Provide your mailing address for samples or product:
Your answer
What is your age range
*
20s
30s
40s
50s
60s
70s
80s+
What is your PRIMARY need:
*
Sensitive Skin Care
Basic Routine, no aging concerns
Early-to-moderate signs of aging
Advanced signs of aging
Mild-to-moderate acne
When you are not using moisturizer, you skin feels....
*
Dry/tight
neither dry nor oily
oily
oily in the T-Zone and dry in other areas
If I could wave a magic wand, you would fix:
*
more radiant-looking skin (fixing dull skin color or color spots)
improved skin texture (fixing acne scars or fine lines)
skin firmness and resilience (improving elasticity)
reducing large pore sizes
extra hydration for dry skin
improve deep wrinkles and expression lines
excess oil
maximum hydration for extremely dry skin
Required
Which concerns do you have around your eye area?
Deep wrinkles, puffiness and sagging
Tired - and puffy - looking
fine lines and wrinkles
gentle makeup remover
Which concerns do you have around your lip area:
fine lines and wrinkles
dry lips
no lip issues
Do you currently have a Mary Kay consultant?
Yes
No
yes...it's you Bree (LOL)
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