About you Ethnicity (optional, helps with pigmentation modelling) (optional) South Asian ✓ East / South-East Asian ✓ Middle Eastern / North African ✓ African ✓ Caucasian ✓ Hispanic / Latin ✓ Mixed / other ✓ Prefer not to say ✓
About you Are you currently pregnant or breastfeeding? We avoid retinoids, salicylic, and other contraindicated ingredients during pregnancy. No ✓ Pregnant ✓ Breastfeeding ✓
Your skin basics Which best describes your skin? Oily — shiny T-zone, frequent breakouts ✓ Dry — tight, flaky, dull ✓ Combination — oily T-zone, normal/dry cheeks ✓ Normal — balanced, low reactivity ✓ Sensitive — reacts easily, redness ✓
Your skin basics Where does your skin get oily during the day? Just the T-zone (forehead, nose, chin) ✓ All over the face ✓ Hardly at all — usually dry or tight ✓ Minimal — feels balanced ✓
Your skin basics How sensitive is your skin? (1 = never reacts, 5 = reacts to almost anything) 1 2 3 4 5 Never reacts Reacts to anything
Your skin basics How visible are your pores? Almost invisible ✓ Small but visible up close ✓ Medium — visible at arm's length ✓ Large / enlarged ✓
Your skin basics Which texture issues bother you? (pick any) (optional) Roughness ✓ Flaking ✓ Tiny bumps / closed comedones ✓ Uneven tone ✓ Fine lines ✓ Loss of firmness ✓ None ✓
Your concerns What's your single biggest skin concern right now? Acne / breakouts ✓ Pigmentation / dark spots ✓ Fine lines & aging ✓ Redness / rosacea ✓ Dullness / lack of glow ✓ Dryness ✓ Oiliness / shine ✓ Sensitivity / reactivity ✓ Dark circles ✓
Your concerns Other concerns (pick up to 5) (optional) Acne ✓ Pigmentation ✓ Aging ✓ Redness ✓ Dullness ✓ Dryness ✓ Oiliness ✓ Sensitivity ✓ Dark circles ✓ Large pores ✓ Sun damage ✓ Pick up to 5.
Your concerns How long has your primary concern been an issue? Less than 3 months ✓ 3–12 months ✓ 1–3 years ✓ More than 3 years ✓
Your environment What's your local climate? Humid (e.g. coastal, monsoon) ✓ Dry (low humidity year-round) ✓ Temperate (mild seasons) ✓ Cold (winter dominant) ✓ Tropical (hot + humid) ✓
Your environment How much sun does your skin see in a typical day? Minimal — mostly indoors ✓ Moderate — commuting, walks ✓ High — outdoor work or sports ✓
Your environment How often do you wear sunscreen? Never / rarely ✓ Sometimes (weekend or when hot) ✓ Daily, no exceptions ✓
Lifestyle How stressed do you feel in a typical week? Low — usually relaxed ✓ Medium — manageable but real ✓ High — most days are stressful ✓
Lifestyle How often do you drink alcohol? Never ✓ Light (1–3 drinks/week) ✓ Moderate (4–7/week) ✓ Heavy (8+/week) ✓
Allergies & reactions Known cosmetic / topical allergens (comma-separated, e.g. fragrance, lanolin) (optional)
Allergies & reactions Have you had any of these reactions to skincare in the past 12 months? (pick any) (optional) Redness or flushing ✓ Burning or stinging ✓ New breakouts ✓ Itching ✓ Excessive dryness / peeling ✓ Hives or swelling ✓ None ✓
Your current routine How happy are you with your current results? (1 = unhappy, 5 = thrilled) 1 2 3 4 5 Unhappy Thrilled
Your current routine What outcomes do you want most from skincare? (pick up to 3) Clearer skin ✓ Glow / radiance ✓ Even tone ✓ Slow signs of aging ✓ Deep hydration ✓ Calmer, less reactive skin ✓ A simpler routine ✓ Pick up to 3.
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