1. Complimentary Skin Care / Health Consultation Client Profile
Name: _______________________________ Date: ___________________
Address: _____________________________ Host: _____________________
City: ________________________ State: ______ Zip: _________________
Best number to reach you: ___________ Best time to call: ________________
Email: ______________________________________________________
Birthday: ______________________ Anniversary: _____________________
Spouse Name: ___________________
SKIN TYPE (circle): Dry Normal Combination Oily Acne Sensitive
My Concerns are (circle all that apply)
* Sensitive skin *PMS *Loss of sex drive
*Dry patches *Sleep disturbances *Mood swings, irritability
*Occasional blemishes *Hot flashes *Suffer from anxiety
*Dark under eye circle *Lack of concentration *Fatigue, loss of energy
*Oily in T-zone area *Depression *Currently dieting
*Sun damage *Get enough fiber *Take vitamins, antioxidants
*Blackheads / white heads *Any known heart disease *Fine lines & wrinkles
*Other ________________
What products are you currently using on your skin? _____________________________________
If you had a magic wand, what would you change about your skin or health?
____________________________________________________________________________________
__
My involvement level with Arbonne at this time is:
1 - I am only interested in product at this time. Foundation Color ____
Other make-up preferences and colors:
2 – I am interested in product, and I would like to
look over some more information.
3 – I am interested in product, and I am definitely
interested in learning how to get MY business
started with Arbonne!
Consultant Notes
I am Interested In (circle all that apply):
*Business Opportunity-35% commission plus overrides
*Hosting a Class – Save 80% on your products
*One-on-One Consultation
*Skin Care
*Cosmetics
*Nutrition
*Weight Loss
*Hormone Balancing
* Gifts
*AutoShip-earn free products w/ your monthly order
*More information on _______________________