□ My skin acts rough, dry or flaky
□ My skin acts oily
□ My skin acts older than I'd like
□ My skin acts sensitive
□ My skin is comfortable with no major problems
□ Other
2. What else concerns you about your skin?
□ Existing lines/wrinkles; lack of firmness
□ Breakouts
□ Hyper-pigmentation/discoloration
□ Preventing the signs of premature aging
□ Dullness
□ Clogged pores
□ Anything else
3. How do you currently care for your skin?
□ Cleanse
□ Tone
□ Serum
□ Moisturise
□ Sunscreen and/or Antioxidant protection
□ Eye care
□ Mask
□ Scrub
□ Other
4. Which of the following are additional concerns or needs for you?
□ Lack of sleep
□ Lack of energy
□ Stress
□ Sun and environmental exposure
□ Using products made with organic ingredients
□ Taking care of my health
□ Other
