Full Name
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Email
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1️⃣ What’s your biggest skin concern right now? (Select One)
Dryness or tightness
Breakouts or congestion
Dark spots or uneven tone
Fine lines or loss of firmness
Sensitivity or irritation
2️⃣ How does your skin usually feel by the end of the day? (Select One)
Tight or flaky
Oily or shiny
Oily in some areas, dry in others
Red or reactive
Balanced but dull
3️⃣ How would you describe your current skincare routine? (Select One)
I have a consistent routine
I’m inconsistent
I use products but don’t see results
I’m not using anything consistently
4️⃣ What’s your top skincare goal? (Select One)
Clearer, healthier-looking skin
Brighter, more radiant skin
Smoother texture
Even skin tone
Younger-looking skin
5️⃣ How important is simplicity in your routine? (Select One)
Very important—I want it easy
Somewhat important
I don’t mind multiple steps
6️⃣ Are you open to personalized skincare guidance?
Yes, I’d love that
Maybe, I’m curious
Not right now—just learning