Check out my personal Beauty questionaire.

1. Representative ID:________
Receive a Personalized Skin Care Recommendation from Deborah Hunter
Create Your Beauty Profile Today
Name (please print): ____________________________________________
Address: ______________________________________________________
City: ______________________________ State: ______ ZIP: __________
Phone – Work: _____________________ Other: ______________________
What is the best way to contact you? (Circle one)
Email Phone Visit
Birthday: __/__
(mm/dd)
Skin Profile
Age (circle one) Under 25 26-35 36-45 Over 45
Skin Type (circle one)
Dry Normal Normal plus oily T-Zone Oily
Face: Skin Concerns (circle all that apply)
None Dull Skin Uneven skin tone or blotchiness Enlarged facial pores
Age spots on the face Deep creases (Forehead or crow’s feet)
Fine lines and wrinkles around eyes Dark circles under eyes
Lips (Fine lines, dry, lipstick feathering) Sagging facial skin
Loss of firmness / elasticity
Skin Conditions (circle all that apply)
None Sensitive Skin Rosacea Adult acne Hyperpigmentation
Broken capillaries
Allergies (circle all that apply)
None Fragrance Fruits: Tropical Fruits: Citrus Lanolins Nuts
Hand & Body: Concerns (circle all that apply)
Cellulite Loose abdominal skin or sagging buttocks Age spots on hands
Breast stretch marks or sagging Stretch marks
Current Skin Care Regimen

2. Do you currently use:
Toner: yes / no Separate Night: yes / no
Exfoliant: yes / no Moisturizer: yes / no Daily UV: yes / no
Which best describes your product usage?
Prefer to use a minimal amount of products, and would like to see a Basic
product regimen of 3 products.
Would like to see a Complete product regimen of all products and treatments
most appropriate.
Which of the following are important when deciding which Skin Care
products to use? (circle all that apply)
Natural Ingredients Anti-aging benefits Beautiful packaging
Cutting-edge technology Products for my skin type
At-home dermatological treatments
Representative ID: _________