Guided by Cherish™️ – Skin Consultation
Let’s get to know your skin.This form helps me understand your skin goals, current products, and lifestyle so I can create your customized plan using Cherished Skin Solutions.
Before we begin, please upload pictures of your skin. Front facing. If these pictures aren't clear, I will ask for them to be retaken. It is very important that I am able to see your skin clearly. Natural, indirect lighting is best.
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Please take a photo of the left side of your face in good lighting.
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Please take a photo of the right side of your face in good lighting.
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Name
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First Name
Last Name
How old are you?
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20 or below
21-26
27-33
34-39
40-46
47-54
55-64
65 or older
Email
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example@example.com
How did you hear about Cherished Skin Solutions?
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Please enter your preferred contact information here
(Phone number, IG handle, etc)
How would you describe your skin? We'll keep it simple not to confuse you.
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Dry (Characterized by small pore size all over. Skin never feels oily & drinks in moisturizing products)
Normal (Small pores on the face with slightly larger pores on the chin and t zone)
Oily (Characterized by large pores over entire face and stays oily throughout the day)
Please choose your current skin concern you'd like to address:
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Acne (Blackheads/Whiteheads/Cysts/Papules/Pustules
Sensitive/Redness
Hyperpigmentation (dark spots & uneven tone)
Aging Concerns (Fine Lines, Wrinkles, Sagging Skin)
Excessive oiliness
Large pores
Acne (Breakouts, Blackheads, Whiteheads, Cystic)
Dull Skin / Lack of Radiance
Uneven Texture
What are your skin goals? (check all that apply and explain below if you choose other)
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Prevent wrinkles
Healthy, vibrant skin
Even complexion
Smooth texture
Please tell us about your skin. How it is currently and how would you like it to be?
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Do you have an event coming up you are aiming to achieve results for?
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Do you have any allergies or sensitivities?
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Do you currently use a regimen twice daily?
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YES
NO
Are you a product junkie? Do you tend to always try new products or do you give your skin 3-6 months before determining if they are effective?
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Do you smoke?
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Yes
No
Are you currently pregnant, nursing, or undergoing hormonal changes?
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Yes
No
How often do you exercise?
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Do you take any medications or supplements? If yes, please list them below.
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How much sleep do you typically get each night?
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If yes to hormonal changes, please explain.
Do you wear make-up?
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Please Select
Yes
No
Do you sleep in your makeup?
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Please Select
Yes
No
Do you have a current skincare routine?
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Please Select
Yes
Somewhat
No
If you answered "Yes or Somewhat" to the question above, what does it consist of? (Check all that apply)
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Cleanser
Toner
Serum
Sunscreen or moisturizer with SPF
Moisturizer without SPF or face oil
Eye Cream
Retinol or Retin-A
Exfoliant
Other
Please list the names/brands of the products you are currently using below. Be very specific here so I can reference what you are currently using and make an appropriate recommendation. I will look each of these products up.
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Of these products, which do you feel have made a difference in your skin? Please explain.
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Please allow 48 hours for a response, and be sure to bookmark our email: hello@skin-junkie.com. Please confirm this notice below.
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