Skin Care Information Survey
Use this survery to gather information from your customers

NAME: _____________________________  TODAY'S DATE:________________
    LOCATION: _______________________  
OCCUPATION: ____________________

        MALE ______ AGE:    UNDER 20 ____   31-40 ____   51-60 ____
        FEMALE ______               21-30 ____   41-50 ____   60 +   ____


    WHAT ARE YOU CURRENTLY USING FOR YOUR SKIN CARE?

________________________________________________________________

________________________________________________________________

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1. How much time do you currently spend washing and caring for your face?
 
 

2. Are you happy with how your skin looks and feels now?
 
 

3. Is it important to you that your skin care products are cruelty-free (not 
    tested on animals, and do not contain animal by-products)?
 
 

4. Is it important to you that your skin care products contain biodegradable
    ingredients and recyclable packaging?
 
 

5. Are you familiar with ingredients that are harmful to your skin?
 
 

6. Do you wonder if your skin care products contribute to the condition,
    look, and feel of your skin?
 
 

7. Would you be interested in the second part of this survey, which is to make
    an appointment to actually experience a mini-facial with a pure, safe,
    herbal and botanically-based skin care line and give your honest opinion? 
 

PHONE: (   )________________        (   )_____________________
                        DAY                                 EVENING

BEST TIME TO CALL: ___________________________________________