Modern Nature Men's Consultation
We are the #1 hair care company in North America, offering naturally based products that REPAIR, GROW and anchor the hair. We bring you the best of both science and nature that together creates the first and only clinically proven anti-aging hair care line in the world! We currently offer product in the United States, Canada, UK, Poland and Ireland!
We Say "NO" to...
Silicones, sulfates, parabens, phthalates, BHT, DEA/MEA, polyethylene glycol, phenoxyethanol, petrolatum, mineral oil, paraffin wax, triclosan, plastic microbeads, formaldehyde releasers, harmful colors and harmful fragrances. No animal testing.
We ARE...
Gluten free, vegan, Leaping Bunny certified and National Hair Loss Association approved.
Name
First Name
Last Name
Email
example@example.com
Phone Number
-
Area Code
Phone Number
Date of Birth
-
Month
-
Day
Year
Date
Country of Residence
Which best describes you scalp? Select all that apply.
Dry
Normal
Oily
Itchy
Flaky
Sensitive
Scalp Psoriasis
Other
Which best describes your hair texture (how thick each strand is)?
Fine
Medium
Thick/Coarse
Not Sure
Other
Which best describes your hair density ( the amount of hair on your head)?
Thin/not a lot of hair
Medium/
Dense/ a lot of hair
Not Sure
Other
Which best describes your hair? Select all that apply.
Short
Long
Straight
Wavy
Curly
Frizzy
Oily
Dry
Tangly
Other
How often do you wash your hair?
Every day
Every other day
Every 3-4 days
Every 5+ days
Other
Do you have any hair loss? If so, which best describes your hair?
Thinning
Some bald spots
Severe balding
Other
What is your current hair routine?
Ex: shampoo, conditioner, gel, mousse, pomade, blow dry, air dry etc.
What is your current haircare brand?
What is your main hair concern and your main hair goal?
Are you allergic to nuts or soy?
Nuts
Soy
Both
Neither
If you are comfortable, please send me a photo of your hair using the button below.
Are you interested in products for skin, women, kids or dogs as well?
Skincare
Women's
Kid's
Dogs
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