Facial Care Survey

Survey

For completing the following survey, jean elizabeth's will send you a free gift with your first order of $15.00 or more! (minimum does not include shipping charges)
Name:
Address:	City:
State:	Zip: Phone:

What is your skin type?	Oily
	Dry
	Normal
Do you use a moisturizer?	Mornings only	Which brands of moisturizer do you use?
	Evenings only
	Both
What is your favorite body cleanser?		Have you found commercial cleaners (including bar soaps) to be drying?	Yes
What is your favorite facial cleanser?			No
What is your favorite facial cleanser?			Sometimes

Do you wear makeup?	Yes	If yes, what is your primary makeup, which brand(s) do you use?
	No
	Sometimes
Do you have sensitive skin?	Yes No	What products have you tried for sensitive skin? Please list products below and tell whether they have helped at all:
Do you have allergies?	Yes No	If yes, list known allergies:
Have skin care products affected your allergies in any way?	Yes No	If yes, please describe:
Did you know that lavender is good for acne?	Yes No
Do you use sun block	Yes No	If yes, which product(s) do you use?
Do you, or anyone you know have psoriasis or eczema?	Yes No	Have you ever tried jean elizabeth's herbal body balm (made with 3 healing herbs)? It contains no petroleum products.	Yes No Comments:
Do you have dry, chapped skin or hands in the wintertime?	Yes No	If yes, what products have you tried to remedy this?
What is your favorite aromatherapy oil?
Would you consider using ours?	Yes No	What scent(s) do you currently use?
Have you ever tried solid perfume made without alcohol?	Yes No	If yes, what brand(s) have you tried?
Do you prefer:	Showers Tub baths Jacuzzi
Do you use different cleansers for showers vs. baths?	Yes No Same for both	Please list kinds or brands:
Do you occasionally need a personal gift and are at a loss as to what to buy?	Yes No Sometimes
Would you consider jean elizabeth's custom gift crates/bags or spa gifts for that special someone?	Yes No Have purchased!	Price range you would prefer:	$15.00-$25.00 $25.00-$35.00 $35.00-$50.00 $50.00 and up

What types of stores do you frequent for purchases of personal care products? Check all that apply:		Department Stores Health Food Stores Gift Shops Specialty Shops Discount Stores
What types of stores do you frequent for purchases of herbal products, vitamins, and supplements? Check all that apply		Department Stores Health Food Stores Gift Shops Specialty Shops Discount Stores
What is your age group?		15-25 26-35 36-45 46-55 56-65 65 and over
From time to time, jean elizabeth's presents new products and/or special seasonal sales. To receive information on new products and upcoming sales, please enter your e-mail address:

Thank you for taking the time to complete this survey. Remember, if you want to receive your free gift, make sure you have filled out your address above! (offer valid with minimum $15 order)

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