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Intake form
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Name
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What type of products are you interested in?
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Skincare
Makeup
Both
What is your skin type?
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Oily
Dry
Combination
Sensitive
Normal
Do you have any specific skincare concerns?
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Acne
Wrinkles
Dryness
Dark Spots
Redness
Sensitivity
What is your preferred method of contact?
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Email
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How did you hear about us?
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What is your age range?
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Under 18
18-24
25-34
35-44
45-54
55 and above
What brands do you currently use?
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