Questionnaire

Properly selected skincare is the foundation of healthy, well-groomed, and radiant skin.

Consultation form – Dyba-Beauty Shop

The first step to perfect skin starts here!

Want healthy, glowing skin? Fill out the questionnaire so that Yulia Dyba, a cosmetic doctor with 15 years of experience, can select a personalized treatment plan for you. Answer a few questions about your skin and lifestyle—this will help us create an effective program that addresses your concerns, from acne and pigmentation to anti-aging care.

Consultation formats

We offer convenient options so you can choose the one that suits you best:

One-time consultation (50 euros): Receive an audio response and a text document with recommendations via Telegram/WhatsApp.
Video consultation 30–45 minutes (65 euros): Personal consultation with Julia Dyba for a detailed analysis of your skin.
4 months of support (€250): Initial consultation + ongoing support via Telegram/WhatsApp, including care adjustments, answers to questions, and tracking of results.

Fill out the questionnaire right now and start your journey to healthy, glowing skin with Dyba-Beauty Shop!

Fill out the questionnaire carefully, describing all answers in as much detail as possible. This will help us diagnose your skin most accurately and select the appropriate products.

Name

Last name

Phone

Date of birth

Country

Describe the climate and weather conditions in your region.

How does your skin feel?

How your skin feels:

Do you experience discomfort after washing your face, and if so, what kind?

Do you experience dryness, tightness, or flaking during the day? If so, where exactly, in which area, and how often?

Describe your skin problems

Is your skin prone to breakouts?

Yes No

What is the nature of the rash?

Where and how often do rashes occur?

Are you bothered by post-acne marks and acne scars?

Yes No

Do you have enlarged pores? Where?

How quickly does skin become oily during the day?

When does your skin get oilier, which season?

Do you have sensitive skin?

Yes No

If you have sensitive skin, describe how it manifests itself.

How often does your skin become red, and how severely?

Do you have rosacea (vascular spider veins on your face)?

Yes No

If you have rosacea, describe its severity and location.

Do you have wrinkles and where are they located?

Do you have pigmentation?

Yes No

If you have pigmentation, describe how severe it is and where it is located.

Describe the condition of the skin around your eyes. Are there any wrinkles in this area? Is the skin prone to dryness? Is elasticity reduced? Are there any circles or puffiness under the eyes?

Do you have any allergies?

Yes No

If you have allergies, please specify what they are and how they manifest themselves.

Do you use makeup?

Yes No

If so, what exactly and how often? What do you use to wash it off?

Are you planning to become pregnant?

Yes No

Are you currently pregnant?

Yes No

Are you a nursing mother?

Yes No

What is your lifestyle like?

- I spend a lot of time outdoors - I spend more time indoors

Are you planning to change your climate in the next 3-4 months?

Yes No

How did you choose your skincare products before?

Describe your current skincare routine in detail. List your morning and evening routines step by step, including the names of the products you use. What skin type are these cosmetics for?

What don't you like about this treatment?

What results do you want to achieve with proper home care?

What are your preferences regarding skincare? What textures of creams do you prefer?

Are there any restrictions on the order amount, and if so, what are they?

What else would you like to add about your skin or previous experience in this matter?

How did you hear about us?

If you are interested in selecting body, hair, hand, and foot care products, as well as decorative cosmetics, please let us know.

Questionnaire

Properly selected skincare is the foundation of healthy, well-groomed, and radiant skin.

Consultation form – Dyba-Beauty Shop

The first step to perfect skin starts here!

Consultation formats

Fill out the questionnaire right now and start your journey to healthy, glowing skin with Dyba-Beauty Shop!

Contacts

Information

Consultation