Account Information

• First Name:
• Last Name:
• Email:
• Phone:
• Current Location:

Basics Information

• What is your date of birth?:
• What is your sex?:
• What is your skin type?:
• What is your skin tone?:

Main Skin Concerns

• Breakouts:
• Hydration:
• Tone:
• Texture:
• Sensitivity:
• Eye Area:

Problem Areas

• Head:
• Body:

Skincare Habits

• Morning routine time:
• Evening routine time:
• Sources of skincare recommendations:

Nutrition Module

• Fruits & vegetables per day:
• High-antioxidant foods:
• Processed/sugary food limitation:
• Daily water intake:

Activity Module

• Exercise per week:
• Session duration:
• Face cleansing after exercise:
• Skincare routine post-exercise:

Sleep Module

• Average sleep hours:
• Sleep quality:
• Wake-up restfulness:

Mental Health Module

• Weekly stress frequency:
• Stress level (1–10):
• Happiness level (1–10):

Your Preferences & Restrictions

Skincare

• Preferences:
• Do Not Use:

Cosmetics

• Preferences:
• Do Not Use:

Haircare

• Preferences:
• Do Not Use:

Bodycare

• Preferences:
• Do Not Use:

Email Permissions

• Personalized Recommendations: Opted in
• New Products: Opted in
• Price Drops & Promos: Opted in
• Routine Reminders: Opted in
• Progress Reports: Opted in
• Environment Alerts: Opted in

Morning Products (Total: )

Evening Products (Total: )