What are your primary skin concerns?
Acne Dryness Wrinkles Dark spots Sensitive skin
How would you rate your current skincare routine?
Excellent Good Fair Poor
Have the skincare products you use been effective?
Yes, very effective Somewhat effective Not very effective Not effective at all
How satisfied are you with your skin's appearance?
Very satisfied Satisfied Neutral Dissatisfied Very dissatisfied
Do you consult with skincare professionals for advice?
Regularly Occasionally Rarely Never
Would you be interested in trying new skincare products?
Definitely Maybe Not sure Unlikely No
All set, how can we reach you?
Name
Email
Phone
(Details here)
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