This document collects contact and health information from a potential Arbonne client, including their name, address, phone number, email, birthday, skin type, health concerns, current skin care products used, and desired changes to their skin or health. It also notes the client's current involvement level with Arbonne and their interests in Arbonne's business opportunity, hosting classes, consultations, or specific product categories.

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 _______________________