1. Get a free sample of our anti-aging cream when you take our survey

* 1. How often do you use skin care products?

* 2. On average, how often do you purchase skin care products?
Choose only one of the following

* 3. On average how much do you spend on skincare products each month?

* 4. Where do you most often buy skin care products?

* 5. Where do you obtain advice or learn about new products?

* 6. I read the list of ingredients on the label before purchasing.

* 7. What skin conditions do you want to treat and how severe are they?

  Not a Problem Mild problem Big Problem
Dry skin
Oily skin
Acne / Blemishes
Sagging skin
Dark spots / uneven skin tone
Dark circles around eyes

* 8. For free sample, please fill out information below.

* 9. Would you like to receive notifications about other special offers by email? These can include free samples of our other products or one-day sales events. By clicking "yes" you also agree to AktaDerm's terms and conditions found at www.aktaderm.com.