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* 1. Email address

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* 2. What is your name?

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* 3. Is your skin oily?

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* 4. Is your skin dry?

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* 5. Do you have combination skin?

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* 6. Would you like a product that helps with fine lines and wrinkles?

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* 7. Would you like smoother skin around your mouth, forehead, and eyes?

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* 8. Do you want to lighten any dark spots?

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* 9. Do you want brighter, tighter skin?

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* 10. Preferred Method of Contact (please list two)

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