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Fill up this questionnaire to win Jewel Range Facials

Name
Gender
Email
What is your age bracket

Below 25 years

25 -35 years
36-45 years
46 years and above
What is your Occupation?

Professional
Business Owner
Trader
Home Maker
What are your most common skin problems for which you would seek professional help?

Acne

Pigmentation
Wrinkles/Fine Lines
Dehydration
Sagging Skin
Under Eye Dark Circles
Stretch Marks
None
Others, Please specify    
What are your most common hair problems for which you would seek professional help?
Hair Fall
Dandruff
Oily Scalp
Dry and Damaged Hair
None
Other, Please specify    
Are you aware of solutions to your skin/ hair problems, If any?
If yes, please do state the solution and who provides it.
No
Yes    
Would you like to know more about your skin or hair type, its maintenance and enhancement?
Yes   No
Skin    
Hair    
How much would you be willing to spend on your skin/hair treatment
Less than Rs.250
Rs. 250 - Rs. 350
Rs. 350 - Rs. 450
Rs. 450 - Rs. 550
Rs. 550 and above
How many treatment sessions would you prefer in a week
1
2
3
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