Survey for Dalâja Clarifying Gel Face Mask

Name

First

Last

Email

Age *

Product Lot Number *

The lot number can be found at the bottom of the container.

Product Smell *

Jasmine, Rose, Mint

Smell Intensity *

Identify the strength of the smell of the product.

Texture / Consistency *

Duration of Use *

Approximate number of days that you used the product.

Frequency of Use *

Once Daily
Twice Daily
Other (Specify Below)

Indicate the number of times the product was used daily.

Time of Use *

Morning
Daytime
Evening
Overnight

The time of day during which the product is applied.

Duration of Application *

The length of time that you left the product on your skin for each application (e.g., 20 min, 8 hrs, 10 hrs).

Absorption Time *

Length of time the product took to absorb into the skin (e.g., 10 secs, 30 secs, 1 min)

Absorbency *

Describe how the product was absorbed into the skin (e.g., absorbed well, left residue).

Experience During Application *

Describe your experience while you were applying the product (e.g., cooling, tingling, irritation).

Experience While Product is On *

How did it feel after the product dried on your skin? Skin became tight, moisturized, sticky, soft, dry, did not feel that it was applied, etc.

Use of Moisturizers *

Yes
No
Other (specify below)

Indicate whether you used a moisturizer after using the product.

Post-wash Experience *

How did your skin/face feel after washing off the product (e.g., skin was soft, smooth, became sensitive, red, etc.)?

Overall Experience *

Describe your experience of the overall use of the product. For example, how it affected your skin: became brighter, reduced/increased pigmentation or wrinkles.

Side-effects *

Describe any side-effects that you may have experienced while using the product.

Your Likes *

Describe what you liked about the product.

Your Dislikes *

Describe what you disliked about the product (e.g., product texture, color, smell, packaging, etc.).

Your Suggestions! *

Make your suggestions to improve the product.

How would you rate this product?

Rating: 0

Rating: 0 – skip; 1 – worst; 2 – bad; 3 – average; 4 – good; 5 – excellent