Skin Type Questionnaire

1
Name* This field is required.
First Name
Last Name
2
Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
3
Phone Number* This field is required.
Please enter a valid phone number.
4
What age range do you fall under?* This field is required.Age can be a factor in your specific skin concerns!
17 or younger
35-44
18-24
45-54
25-34
55+
5
Where do you call home?* This field is required.Different environments and climates call for different skincare approaches!
Sunny & humid topical vibes
City dweller
Temperate with cold winters & mild summers
Dry & hot desert
Cold & dry year-round
6
How much time do you usually spend in the sun?* This field is required.
Very little: Less than 3 hours per week
Moderate: 24 hours per week
A lot: 48 hours or more per week
7
What type of routine would you like?* This field is required.We want to take into account your lifestyle and preferences.
The Basics - 3 Steps
The Foundation - 5 Steps
The Signature - 10 Steps
mJust looking for a few product recommendations, not a routine!
8
How much time do you set aside to take care of your skin before bed?* This field is required.
Less than a minute - to wash and dry my face
A few minutes - to thoroughly wash my face, dab on a spot treatment or eye cream and moisturize
Five minutes or so - I typically wash my face, exfoliate or wash-off mask occasionally, apply a serum and moiturize
Seven to ten minutes (or more!) - I like to have a more involved routine at night to treat and care for my skin
9
How do you wash your face?* This field is required.There's no wrong answer!
Just water
Warm water + a foaming cleanser
Warm water + an oil based cleanser
Warm water + an oil based cleanser followed by a foaming cleanser
I don't regularly cleanse
10
Which skin care products are you most interested in adding to your routine?* This field is required.Certain ingredients help to address specific skin needs. Pick you favourite!
Ones that have acid in them
Ones that stimulate collagen production and reduce wrinkles
Ones that contain Vitamin C
Ones that protect and repair skin
Ones that are nourishing and hydrating
11
On a scale of 1-5, how reactive would you consider your skin?* This field is required.
1 (Hardly reactive at all, I can use all products)
2
3 (Somewhere in the middle, it depends on the ingredients)
4
5 (Very reactive/sensitive, I frequently experience redness)
12
Which of the following best describes your skin?* This field is required.Though everyone's skin produces oil, sometimes it's more apparent or obvious in some skin types than others.
Rarely gets oily; feels and looks dry
Not too oily or too dry; overall feels balanced
Some oiliness on my forehead and cheeks; tends to be more noticeable at the end of the day
Very oily; has a shiny appearance throughout the day
13
When I wake up in the morning, my skin feels ___________.* This field is required.
Slick and shiny
Rough and bumpy
Just fine! Nothing out of the ordinary
Tight and uncomfortable
14
How frequently do you get acne or breakouts?* This field is required.
Not very often, and when I do it's easy to manage
Often, or hormonally
Very frequently, and it's difficult to manage
15
What is your main skin care goal?* This field is required.
Getting rid of acne
Minimizing fine lines and wrinkles
Fading dark spots
Soothing redness and irritation
Achieving dewy skin
16
What do you value most in skin care products?* This field is required.
Affordable price point
Vegan beauty
Clean beauty
Quick results
17
How often do you workout?* This field is required.Breaking a sweat is great, but can also cause breakouts.
Never
1-2 times a week
3-4 times a week
Everyday!
18
On average, how would you rate your overall stress levels?* This field is required.Stress can impact your physical and mental health (and also, your skin!)
1 (minimal daily stress)
2
3 (average stress levels)
4
5 (stress is a constant presence)
19
Have any big events coming up that you want to look your best for?* This field is required.
Yes
No
20
We'd love to help!* This field is required.Which event do you have coming up?
Wedding/Anniversary
Graduation
Birthday
Pregnancy
Other
21
Do you regularly undergo aesthetic facial treatments?* This field is required.Select all that apply:
Facials or Chemical Peels
Microdermabrasion
Dermal Fillers
Laser Hair Removal
Botox
Other
None of the above
22
Describe Other:* This field is required.
23
What are your go-to skin care products?* This field is required.We want to know what's worked best for your skin in the past.
Should be Empty: