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Complimentary Skin Analysis at BeautynHealth.com


BeautynHealth.com's trained Estheticians can give you a complimentary skin analysis and create a custom skin care program for you by filling out the questionnaire below. Our skin care experts will evaluate your answers and then guide you through which products would be appropriate for you to purchase from us and use as suggested. The end result is that you'll have a wonderful customized skin care regime designed specifically for you!

Please allow 1-2 business days for our Estheticians to respond.
First Name   Last Name
Address
City       
State   Zip Code
Phone      
E-mail      
Age      
Gender      
1. What Product Lines and/or Products have you used before?
 
  and what were your results?
 
2. What skin type do you think you have?
 
3. What are your problem areas?
 
4. What type of climate do you live in?
 
5. How do the changing seasons affect your skin?
 
6. If you could change anything about your skin, what would it be?
 
7. Do you have any allergies?
 
8. What are your skin care goals?
 
9. Have you ever received a skin analysis from us or any other specialist?
  Yes No
If yes, what products were suggested and what were your results? Who recommended them?
10. Are you on any Medications?
  Yes No
  If yes, which ones?
 
11. Do you travel frequently ?
  Yes No
  If yes, where do you travel to and what type of climate is there?
 
12. Do you use Sun Protection?
  Yes No
  If yes, what kind?
 
13. Do you spend a lot of time in the Sun?
  Yes No
14. Are you drinking coffee on an empty stomach?
  Yes No
15. Do you drink enough water daily? (minimum 48 oz.)
  Yes No
16. Do you like to wear foundation?
  Yes No
17. Would you like our nutritional counselor to suggest a vitamin-mineral-amino acid program that would greatly benefit your skin, nails and general health?
  Yes No
18. Will you be including a photo? JPEG format is the best - yourname.jpg. Pictures are not necessary for a thorough analysis, however it is always helpful. Please email photos to skinanalysis@beautynhealth.com
19. How did you hear about our company: From the Heart BeautynHealth.com (Please be as specific as possible)?
 
20. Any other comments or questions please list them here.
 
21. What Product Line are you interested in? (leave blank for our Esthetician to recommend based on your answers above)
 
 
BeautynHealth.com : The Leader in Beauty and Health