Rejuvenate Your Skin with Dr Ilana
Using the right naural-based, vegan products tailored for your skin will rebalance your skin for the best results. By giving you the best of both nature and science while using only the finest quality and high-performing ingredients. So you can love the skin you are in.
Name
*
First Name
Last Name
Email Address
*
example@example.com
Mobile/Phone Number
*
Please enter a valid phone number.
Format: 0000 000 000.
What is your Instagram handle?
@ilanasowterofficial
1. How do you prefer to be contacted?
*
Text/Instagram/Email/Telephone
2. What is your age range?
*
20's
30's
40's
50's+
3. What is your biggest concern about your skin?
*
Acne
Blocked Pores
Fine Lines/Wrinkles
Dark/Age Spots
Dullness
Dark Circles
Redness
Scarring
Large Pores
Puffy Eyes
Texture
Eczema
Psoriasis
Roseacea
Melasma
Other
4. What is your skin type?
*
Oily
Dry
Combination
No Idea
Normal & balanced
Sensitive
Other
5. What would you love to improve about your skin?
*
6. Do you have any allergies or any other skin concerns?
*
7. How much make up do you use per day?
*
None
A little
A decent amount
Full coverage
8. How often do you feel that your skin is sensitive?
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Never
Rarely
Sometimes
Always
9. Do you feel stressed about how you look and feel?
*
Yes
No
10. Do you experience any of the following medical conditions?
*
Asthma
Eczema
Allergies
Rosacea
No
Other
11. What type of weather do you experience where you live?
*
Sunny & Tropical
City dweller
Cold winters & mild summers
Dry & hot desert
Cold & dry year-round
12. How much time do you spend to take care of your skin per day?
*
Less than a minute
A few minutes
Around 5 minutes
More than 7 minutes
13. How do you wash your face?
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Just water
Water and a foaming cleanser
Water and an oil based cleanser
Other
15. I am interested in:
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Trying some products
Earning an extra income (plus 30-55% off)
15. Are you interested in trying:
*
Men's Range
Haircare range: strengthen & grow with salon results
Not at the moment
Other
14. How much would you like to spend for a 6-12 month period on naturally-based skincare that give results?
*
$100 to $300
$500 plus
$300 to $500
Other
Submit
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