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Free Skincare Consultation

Please complete this questionnaire and be on the lookout for your Custom Regimen!
Gluten Free – Paraben Free – Sulfate Free – Made in the USA

Name(Required)

First Last

Email(Required)

Age

Teen

20's

30's

40's

50's

60's and up

Tell me about your skin

Dry

Oily

Combination (Normal with oily T zone - Nose, Forehead, Chin)

Normal (not too oily or too dry)

Which area(s) of your skin would you like to work on the most?

Check all that apply

Acne

Rosacea or any excess redness

Fine Lines

Under eye Cirlcles/Puffiness

Dark Spots or uneven skin tone/Hyperpigmentation

Enlarged Pores

Dullness

Wrinkles

Other

What Products are you interested in?

Check all that apply

Surprise Subscription box ($60 for $200 worth of skincare, cosmetics!)

Cleanser

Serums

Moisturizers

Night Treatment

Acne Treatment

Masks

Eye Creams

Neck and Decolette Repair

Anti-Aging and oil free foundation

Any Other Make Up Items

Do you have Sensitive Skin?

Yes

No

Do you have acne prone skin?

Yes

No

Are you willing to wear sunscreen daily?

Yes

No

Comments

Is there anything you would like to share with me regarding your skin, routine, or preferences?

How do you prefer me to share your results?

Give detailed information about each product for you to go over and decide which ones you would like

You give me your budget and trust me to show you exactly what I recommend you order

Send me links to each item so I can look and order

Comments

This field is for validation purposes and should be left unchanged.

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Clar Beauty

Clarice V Watkinson
clarice.v.watkinson@gmail.com
(401) 954-2089
Saunderstown, Rhode Island 02874
United States

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