Name
Cell Number /text
E-mail
My age
Teen
20s
30s
40s
50s
60s
70s+
My skin is
dry, uncomfortable with signs of aging
red, irritated, dry, sensitive
uneven looking skin, hyperpigmentation
oily, acne prone with blackheads, breakouts
fine lines, loss of tone, wrinkles
combination skin with oily t-zone
normal, no issues - want to maintain
sensitive to fragrance
I usually use
Cleanser, toner
peels, scrubs
serums
day cream
SPF
night cream
retinol or glycolic acid
I use very little. not sure what to use
I have difficulty finding skin care because
I breakout with new products
I have allergic reactions, ie rashes
my skin is dry, no matter what I use
I dont like a greasy feel on my skin
none of the above
I am interested in
a full skin care regimen
a very basic skin care routine
a cleanser
a toner
a serum
a face cream
a SPF
I prefer my skin to feel after product application
richly hydrated
lightweight
I would like to learn more about
LightStim LED Therapy @ Home
BT Sculpt @ Home Microcurrent
Diego Dalla Palma Professional
Eco Pink Skin Care
Pink Avenue Skin Care - Products of Canada
Pink Avenue Medical Grade Skin Care
I am located
in the GTA.
Outside the GTA
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