Your Full Name

Your Phone Number

Email Address

Physical Address

1. My Natural Hair Color is (choose one):

Blond Brown Red/Auburn Dark Brown Black Gray Silver/White

2. My Natural Eye Color is (choose one):

Blue Brown Green Dark Brown Hazel Green Hazel Blue

Do you know your eye shape? (hooded, wide set, narrow set, standard, etc.)

3. Are your lips small or full (choose one): Small/thin Full
Which type of lip colors do you like (choose one): Bright Neutral Dark

4. My Skin Tone is:(choose one):

Warm (golden undertones, very little pink) Cool (pink, red undertones)

5. Choose the Sun exposure statement that best describes you:

I burn so easy...call me a lobster!
I will eventually burn without sun protection
I never burn

6. For my Dominant Ethnic Heritage, My Skin Color is(choose one):

Very Fair Fair Medium Dark Very Dark

7. My Dominant Ethnic Heritage is(choose one):

Caucasian (Anglo) Hispanic African-American Asian Native American

8. I Would Describe My Skin Type As: (choose one):

Normal Dry Oily Combination Sensitive Blemish-Prone

9. My Age is (sorry to ask but it does help):

10. Which type of look would you like? Natural Classic/Career Glamour/Special Occasion

11. Is there anything else you would like me to know about your skin condition and color preferences: