SKIN Care Survey

How would you describe your skin type? * Select... Oily Dry Combination Normal Sensitive

Do you currently have any of the following skin concerns? Acne/Pimples Pigmentation or Dark Spots Redness or Inflammation Fine Lines/Wrinkles Dark Circles Dull Skin Sunburn/Tanning Itching or Flakiness

Do you experience seasonal changes in your skin condition? * Select... Yes No Not Sure

How often do you use sunscreen? * Select... Daily Occasionally Rarely Never

How often do you exfoliate or use scrubs? * Select... 2-3 times a week Once a week Rarely Never

Do you follow a balanced diet? * Select... Yes Sometimes No

Do you take supplements (e.g., biotin, vitamin D, omega-3)? * Select... Yes No

How often do you consume water daily? * Select... Less than 4 glasses 5–8 glasses More than 8 glasses

Do you smoke or consume alcohol regularly? * Select... Yes Occasionally No

Do you face high stress levels frequently? * Select... Yes Sometimes No

Do you have any of these medical conditions? Thyroid PCOD/PCOS Diabetes Hormonal imbalance None

Are you currently on any medications that may affect your skin/hair? * Select... Yes No Not sure

Have you had Covid or other major illness in the past 12 months? * Select... Yes No

How often do you wash your face/hair? * Select... Once a day Twice a day More than twice a day

Which of the following do you use regularly? (Select all that apply) Facewash Toner Moisturizer Sunscreen Serum Anti-acne/anti-aging cream Face mask/scrub

What kind of shampoo do you use? * Select... Sulfate-free Medicated Regular commercial Ayurvedic/Natural

Do you use hair oil or hair serum regularly? * Select... Yes (Oil) Yes (Serum) Both No

Have you undergone any of the following treatments in the last 6 months? * Select... Chemical peel / laser / derma facial Hair smoothing / straightening / color PRP / mesotherapy for hair None