Skin Consultation
Are you unhappy with the state of your skin? If this is the case, maybe it's time for some quality skincare! The luxury brand I represent is a global healthy-aging haircare and skincare innovator and has been recognized as one of the fastest-growing private companies in America, offering naturally-based products we are bringing YOU the best of both nature and science, using only the finest quality and high-performing ingredients from all over the world.. Open in the USA, Canada, United Kingdom, Poland, Ireland, Spain, Lithuania & Australia These products are: Vegan Anti-aging Clinically-tested Scientically-proven & Designed to improve quality of your skin NO SILICONES! NO SULFATES! NO PARABENS! NO HARSH CHEMICALS! NO PHTHALATES! NO PLASTIC MICROBEADS! NO HARMFUL FRAGRANCES OR COLORS! GLUTEN FREE! 100% VEGAN! I look forward to helping you achieve all your skincare goals! My products are skin type specific so, Please tell me a little more about your skin so I can help get you started on a healthy skin regimen customized just for you.
Let’s talk skincare
Name
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First Name
Last Name
What is the best way to contact you? (Example: Phone number, Email, Instagram handle, zoom)
*
What is your date of birth?
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Month
-
Day
Year
What are your skin goals?
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What skin type do you have? (check all that apply)
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Dry
Oily
Normal
Sensitive
Dull
Rough texture
Dehydrated
Not sure
What concerns do you have about your skin? (Check all that apply)
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Dark spots
Under eye puffiness
Large pores
Hyperpigmentation
Blackheads
Fine lines or wrinkles
Dark circles
Face redness
Aging
Scaring
Stretch marks
Other (we can discuss)
None
Is there something that caught your eye that you may be interested in trying for your skin or hearing more about? (check all that apply)
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Berry scrub
Makeup remover balm
Vegan retinal
Collagen key
Under Eye cream
30 second miracle
Body care
Other (we can discuss)
None at this time
Do you suffer with any skin conditions? (Check all that apply)
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Acne breakouts
Rosacea
Psoriasis
Eczema
Hormonal acne
Sebaceous Filaments
Melanoma
Hyperpigmentation
Other (we can discuss)
Do you have any allergies I need to know about?
Is there anything else you would like me to know about your skin?
*
I’m mainly interested in
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Purchasing non toxic products & starting a new skincare regimen
Hearing more about earning an extra income (+ getting 30% off)
What other products are you interested in hearing more about?
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Hair Care
Junior Line
Pet Products
Body care
Men’s line/Beard products
Wellness (pre/probiotics, greens, collagen, energy)
None at this time
Are you interested in hearing more about my most popular product Rejuveniqe Oil? (Our holy grail)
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Yes, tell me more
No, not at this time
Submit
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