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Skin Assessment

SKIN IDENTITY

Q1. How does your skin feel when you wake up?

*

A

Tight or dry

B

Oily or greasy

C

Balanced

D

Irritated or red

E

It changes daily

Q2. How would you describe your skin type?

*

A

Dry

B

Oily

C

Combination

D

Sensitive

E

Balanced

Q3. What are your top skin concerns?

*

Q4. How reactive is your skin?

*

A

Very sensitive — reacts easily

B

Sometimes reactive

C

Rarely reactive

LIFESTYLE & ENVIRONMENT

Q5. How much water do you drink daily?

*

A

Less than 32 oz

B

32–64 oz

C

64–100 oz

D

100+ oz

Q6. How's your sleep, on average?

*

A

Less than 5 hours

B

5–6 hours

C

7–8 hours

D

8+ hours

Q7. Current stress level?

*

A

Low

B

Moderate

C

High

D

Very high

Q8. What kind of climate do you live in?

*

A

Dry

B

Humid

C

Seasonal mix

WHAT'S CHANGED

Q9. Has anything shifted in the last 3–6 months?

*

Q10. What do you want your skin to feel like?

*

A

Calm and comfortable, not reactive

B

Hydrated and plump

C

Firmer and smoother

D

Clear and even

First Name

*

Email address

*

What is your age range?

*

18-24

25-34

35-44

45-54

55+

Do you have any Food allergies or restrictions?

Do you have any skincare ingredients allergies?

*

I consent to being photographed and/or recorded during the RAAH Soul & Skin Reset and give RAAH permission to use these photos and videos for marketing and promotional purposes, including social media, our website, and other digital media.

*

Yes