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Client Profile Sheet - DOC 1

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					                                                      Client Profile Sheet

                GIRLFRIEND INFORMATION:                                                      Questionnaire To Answer:
Last Name: __________________ First: __________                                          Take a quick glance in a mirror and
Date: _________ Spa Diva Hostess: _____________                                          answer a few questions:
                                                                                         1. If you could change anything about
Your Address: _________________________________
                                                                                         your skin, what would it be? What do
City: ___________________ State: ____ Zip: _____                                         you want help fixing? _____________
                                                                                         ______________________________
Cell Phone: _________________________                                                    ______________________________
Home Phone: _______________________                                                      ______________________________
Other: __________________________                                                        ______________________________
Best Time To Call: ________ am/pm
                                                                                         2. What are you currently doing/using
                                                                                         to Maintain, Repair, and Protect your
Email: _______________________________________                                           skin? Ie brand, regimen? ___________
Birthday: _____ Anniv: _____ Spouse Name:_________                                       ______________________________
Age Group (circle): 18-29 30-39             40-49 50+ Acne Sensitive
                                                                                         3. What results are you seeing with it?
Are you a mom? _________                                                                 What do you like about it? _________
Social Groups You Are In That Might Enjoy a Spa Session (ie book                         ______________________________
                                                                                         ______________________________
club, garden club, wine club, pta/moms club etc..): ___________
Check off Which Applies:                                                                 4. What don’t you like? (cost, not
◊ domestic goddess ◊ employed ◊ I want to change jobs                                    convenient, not simple, no personal
◊ could use some extra cash each month for everyday expenses                             service) ________________________
◊ retired ◊ un-employed                                                                  ______________________________
Employer: ___________________ Title: ____________                                        ______________________________
◊ PT ◊ FT
                                        I am Interested in More Information on the Following:
                           ◊ I would like to learn how to SAVE up to 50% off on all Spa, Skin care & Makeup.
             ◊ I would like to learn how to earn and extra $500-$1000 per month working only 4-8 hrs around my schedule.
               ◊ I would like to have a complimentary Head to Toe Update on my skin, spa and cosmetics customization.


                SKIN CONCERNS:                               BODY CONCERNS:                     MAKEUP / IMAGE CONCERNS
◊ very dry                         ◊ oily skin          ◊ sun protection for body          ◊ I want a new look & know my best colors
◊ fine lines and wrinkles          ◊ occasionl acne     ◊ dull skin                        ◊ I need application tips/techniques
◊ puffiness in jowels & face       ◊ chronic acne       ◊ dry skin / itchy skin            ◊ I need a lipstick that stays put w/out dryng
◊ dark circles                     ◊ chapped lips       ◊ age spots / freckles on body     ◊ I need a great eye makeup remover that
◊ crows feet / lines around eyes ◊ large pores          ◊ body acne                        doesn’t leave oily residue or sting
◊ fine lines around lips                                ◊ dry/damaged cuticles             ◊ I want makeup to last longer
◊ rough texture / dull skin                             ◊ dry hands                        ◊ My eye liner smudges
◊ blackheads                                            ◊ cellulite                        ◊ My mascara smudges / need waterprf
◊ loss of firmness                                      ◊ stretch marks                    ◊ I need a new lipstick color
◊ age spots/freckles/skin discolor                      ◊ keeping bra straps in place      ◊ I want to cover up (circle):
◊ rosacea &/or sensitive skin                           ◊ want to tighten skin on body     - red patches – dark circles – yellow
◊ sun protection                                        ◊ dry / damaged feet               ◊ Interested in Anti-Aging Makeup
     MY BEAUTICONTROL WISH LIST: Things I am Interested in That I Enjoyed Tonight
            My Skin Care MRP Wish List:                                          My Special Skin Solution Wish List:
I am in (circle) 20’s, 30’s, 40’s, 50+, acne, sensitive                  o Herbal Hydrating Mist (refresher & sets makeup)
Maintenance:                                                             o Lip Apeel Scrub & Balm (for chapped dry lips)
◊ skin care cleansing set (cleanser, scrub, tonic, moisturizer)          o Platinum Anti Aging Lip Treatment (for lines &
Repair:                                                                    aging lips)
◊ skin serum                                                             o Platinum Eye Repair Patches (for bags under eyes)
◊ Tight Firm & Fill (TFF) aka botox in a bottle                          o Chemical Peel (for large pores)
◊ Microderm Abrasion buffer & creme
◊ eye repair crème                                                                      Spa Product Wish List:
◊ Retinol Eye Capsules                                                   □ Warming Green Tea Masque (warming masque)
◊ Retinol-Time-To-Go for the face                                        □ Cucumber Eye Pads (for itchy, dry eyes, headaches)
◊ Cell Block C Brightening Elixir                                        □ Luxuries of Sea Mud Masque for face & body
Prevention:                                                              □ Detox Peppermint Bath Soak / Aromatherapy
◊ Cell Block C SPF                                                         (for arthritis, aching muscles, headaches & sinuses)
◊ Cell Block C PM (for after Microderm Abrasion)                         □ Show of Hands Instant Manicure Scrub & Hand
 (if in 50+ line it would be your night crème in your maintenance set)      Crème (for damaged cuticles and hands)
◊ Cell Block C Intensive Multi-Vitamin Capsules                          □ Save Your Sole Salve (blue salve/putty for cracks in
                                                                            heels and dry feet)
    I Use/Like the Following Types of Makeup:                            □ Margarita Foot Crème (for dry feet & arthritis)
∆ Mascara                  ∆ Lipstick            ∆ Primers               □ Herbal Serenity Foot Crème (peppermint melon)
∆ Eye Liner                ∆ Lip Gloss           ∆ Foundation            □ Anti Ash Crème (pantyhose in a bottle for shiny legs)
∆ Eye Shadow               ∆ Blush               ∆ Concealers            □ Awaken Body Line (grapefruit, lime, citrus)
∆ Shadow Control Crm       ∆ Bronzers            ∆ Wrinkle Deflector     □ Relax Body Line (lavender, chamomile)
∆ Eye Makeup Remover       ∆ Lip Line Filler     ∆ Lash & Brow Cond
                                                                         □ Snowflake Winter Collection

				
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posted:7/13/2011
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