I’m excited to get to know you and your skin! Once you submit all of your answers, I will recommend a personalized skincare routine using our clinically proven Pomifera products! Please allow up to 24 hours for a response.
Name
First Name
Last Name
Email
example@example.com
What is the best way to contact you?
Email
FB Messenger
Text
Please input your preferred contact here
(Phone number, email, Facebook)
How would you describe your skin?
Dry
Normal
Oily
Combination
After you wash your face, it feels:
Tight or Dry
No reaction
Slight sheen
Oily
How does your skin feel a few hours after using moisturizer?
Dry
Oily
Dry in some areas
I don’t use moisturizer
What are your skin goals? (check all that apply)
Prevent wrinkles
Dark spots
Better, healthier skin
Address my skin concerns
What are your face and/or body skin concerns? (check all that apply)
Redness
Fine lines/wrinkles
Loss of firmness/elasticity
Hyperpigmentation
Acne
Dryness
Rosacea
Dull skin
Stretch marks
Facial eczema
Body eczema
Psoriasis on scalp
Psoriasis on body
Dry/cracked lips
Cold sores/fever blisters
Other
How old are you?
Under 20
21-26
27-33
34-39
40-46
47-54
55-64
65+
Do you wear makeup?
Every day
Occasionally
Never
Do you have a current skincare routine?
Yes
No
If yes, what does your routine consist of?
Cleanser
Toner
Serum
Sunscreen/moisturizer with SPF
Face oil/moisturizer without SPF
Eye cream
Exfoliator
Retinol
Other
Are you looking to replace your current products?
Yes, all of them
Yes, some of them
No
Are you allergic to any skincare ingredients? (if so, please list below)
Are you interested in our hair or body products?
Yes
No
Would you like to partner with Pomifera?When you partner with us you will not only get paid for sharing our products with those you know, but you will also be compensated if you gather people who want to partner and share the brand right along with you.Order a business box ($99) and receive a variety of the Pomifera Brand Products, a replicated website that your referrals can order directly from, as well as instant access to your Owner's Suite that puts running a small business right at your fingertips. No monthly or yearly fees, ever!Whether you choose to partner as a part time hobbyist or you have big goals for building substantial incomes, we are proud to have you as part of the Pomifera family.Are you interested in the Pomifera opportunity?
Yes! Sign me up
I would like more information
I want to try the products first
Not at this time
Not interested
Questions, comments or concerns?
How did you hear about Pomifera and this quiz?
Facebook
Instagram
Friend/family
Other
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