Questionnaire

Personal Advice Questionnaire

It is important you answer all questions so we can give you the best advice possible

Personal Information

Name

Address

Telephone

Is this advice for you or someone else? If it is for someone else please answer the questions as if you were them

You Someone Else

Please mark the product areas you are interested in

Massage

Bath

Body Care

Facial Care

Hair Care

General use essential oils

In order to make recommendations that are suitable and safe we need to know a little about you

Gender

Age

Have you had advice from us before?

Yes No

Do any of the following apply to you?

Pregnant

Hypertension

Seizures

Nut Allergy

Any other allergies

Please specify

Any skin complaints

Please specify

Please place the following fragrences in order of preference. (click on one or more and use the up and down buttons to move into the correct position)

Most liked

Least liked

Now we need to build a better picture of who you are and therefore which oils will appeal to you. Please select the item of each pair that you prefer. We find this most effective if you answer it as quickly as possible. Don't worry if some of the questions seem strange!

Indoors / Outdoors

Flowers / Spices

Light and Fresh / Warm and Comforting

Urban / Rural

Tropical beaches / Snow and log cabins

Please indicate whether your levels of the following are low, medium or high

Low

Medium

High

Stress

Energy

Concentration

Patience

Anxiety

Facial Care products section



Which one of the following best describes your facial skin type
	Indicate any of the following that apply to you
Spots and blocked pores
Acne
Blemishes
Fine Lines
Wrinkles
Loss of elasticity
Tired and grey skin
Flaky skin

	How long do you spend on your facial care routine?
Morning
Night

Haircare products section



How would you describe your hair type?
Which one of the following best describes your current hair colour?
	Indicate any of the following that apply to you
Flat or Lifeless
Dry or damaged
Flyaway or Frizzy
Dull
Dandruff or flaky skin
Sensitive Scalp

Which of the following would you most like your hair to have?

Is there any other information you feel would help in making your recommendation?

This is your chance to tell us about any problems not mentioned before or any oils you know you particularly like or dislike



	On which areas of the body are you planning to use your oil?
Body
Face
Hands
Feet

	Would you like your oil to help with any of the following?

Stress
Mental fatigue
General aches and pains
Muscle tension
Painful Joints
PMT
Toning the skin
Combatting Cellulite
Nourish and Moisturise
Other	Please specify -

Which one of the following would best describe your ideal oil?

At what time of day will you use your Massage Oil



	Indicate any of the following you would like to use your bath to help with
Stress
Mental fatigue
General aches and pains
Muscle tension
Painful Joints
PMT
Toning the skin
Combatting Cellulite
Nourish and Moisturise
Other	Please specify -

Which one of the following would best describe your ideal oil?

At what time of day do you normally bathe



Which one of the following best describes your body skin type

How sensitive is your skin

	Indicate any of the following you would like to use your body care products to help with
Stress
Mental fatigue
General aches and pains
Muscle tension
Painful Joints
PMT
Toning the skin
Combatting Cellulite
Nourish and Moisturise
Deep Cleansing
Other	Please specify -

Which one of the following would best describe your ideal body care product?