TeriLyn Adams Skincare Questionnaire

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Hi! I'd love to help you get on a skincare routine that works! Fill out the information below and I'll get back to you with recommendations ASAP.

In the meantime, sign up for skincare 101 mini course here so you can learn how to best use whatever products you have! https://terilynadams.ck.page/0f911dcd65

Thanks!
TeriLyn

terilynadams.com

Email *

1. Your name: *

Did you drop your email address for my skincare emails? If not, click the following link to sign up: https://terilynadams.ck.page/0f911dcd65 *

Yes, just did it!

Phone Number (so I can text you about promos!)

2. How old are you?

Under 18

18-24

25-29

30-34

35-45

46+

Clear selection

3. What is your skin type? *

Normal (no or few blemishes, balanced, etc.)

Oily (dull or shiny complexion, blackheads and breakouts more common, large pores common)

Dry (dull complexion, often feels tight)

Combination (areas of both dry and oily skin usually along the forehead, nose, and chin)

Sensitive (does not tolerate many products well , redness, irritation, itchy, burning common)

Not sure!

4a. What's your primary skin concern? *

active acne / too much oil

dryness

fine lines

dark spots, pigmentation, discoloration

acne scars

sagging skin

dullness

large pores

redness

no major concerns - just want safer products

Other:

Required

5. If you have had a reaction to skin care products before, please tell me more about what products and what happened.

6. What does your current skincare routine consist of? (Please list the brand/company and what you like/dislike)

Choose your interest level with a new skincare routine: *

I'm a minimalist, soap and a moisturizer works for me.

I'm interested in a new routine, but would like to limit it to 4 products.

I want things to add to my existing routine (masks, vitamin C, etc.)

I'm interested in a complete new regimen.

8. Do you need/want makeup recommendations? *

Yes

Nope

9. If interested in makeup, please tell me a little bit about which products you currently use and would be interested in replacing. *

10. Are you interested in becoming a skincare consultant? *

Yes, I want to learn more!

No, not right now

Maybe! Gotta think about it.

Please list any other concerns or questions you might have here. Happy to help!

Submit

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