Name and Surname: Click Here to Enter Text

Skin hair care products questionnaire

Name and Surname: Click here to enter text.

Mobile number: Click here to enter text.

Email address: Click here to enter text.

What is your gender? Choose an item.

What is your age group? Choose an item.

Which race / ethnicity best describes you? Choose an item.

How would you describe your skin type? (Check all that applies)

Dry ☐

Normal ☐

Oily ☐

Oily with acne ☐

Combination ☐

Sensitive ☐

+ Dehydrated ☐

Which products do you use in your regular daily skin care routine? (Check all that applies)

Face wash (cleanser) ☐

Face Toner ☐

Face and Neck serum ☐

Moisturizer ☐

Eye cream/serum ☐

Sunscreen ☐

Makeup remover ☐

Which type of face care products are you using? (Check all that applies)

Day Cream ☐ Face Toner ☐

Night Cream ☐ Makeup remover ☐

Face and Neck Serum ☐ Face wash ☐

Eye Serum ☐ Lip Balm ☐

Face Scrub/exfoliator ☐

Which type of body care products are you using? (Check all that applies)

Hard Soap ☐ Body Scrub ☐

Liquid Soap ☐ Sun Care / Sun Protection ☐

Body Lotion ☐ Hand Cream ☐

Body Butter ☐ Foot Cream ☐

Body Oil ☐

How would you describe your hair? (Check all that applies)

Dry ☐

Normal ☐

Oily ☐

Oily with dry ends ☐

With dandruff ☐

Which type of hair care products are you using? (Check all that applies)

Shampoo (regular) ☐

Shampoo (medicated) ☐

Conditioner ☐

Pre-wash moisturizer ☐

Oil for split ends ☐

Hair spray ☐

Styling gel ☐

How often do you wash your hair? (Check all that applies)

Daily ☐

3 times a week ☐

2 times a week ☐

Once a week ☐

Less than once a week ☐

Any known allergies? Choose an item.

if “Yes” please specify: Click here to enter text.

What are your favourite essential oil fragrances? (Check all that applies)

Lavender ☐ Patchouli ☐

Rose ☐ Frankincense ☐

Rosemary ☐ Lemon ☐

Neroli (Orange flowers) ☐ Orange ☐

Coconut ☐ Vanilla ☐

Tea tree ☐ Palmarosa ☐

other (specify): Click here to enter text.

Are you willing to try handmade natural/organic skin hair care products? Choose an item.

Thank you for taking the time to complete this survey 2/2