Hair Consultation

Welcome to Modern Nature Haircare!

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 toxic ingredients such as...

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*
Email*
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Date of Birth*

MonthDayYear
Country of Residence*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
What best describes your scalp? Select all that apply*

drynormalitchyflakysensitivescalp psoriasisOther
Which best describes your hair texture? (How thick each strand is)*

finemediumthick/coursenot sureOther
Which best describes your hair density (the amount of hair on your head)?*

thin/ not a lot of hairmediumdense/ a lot of hairnot sureOther
Which best describes your hair? Select all that apply.*

frizzynot frizzydamagedbrittle/breakingoilylifelesstangles easilydryvery drycolor treatedOther
Which best describes your hair? Select all that apply.*

curlywavystraightvery shortshortshoulder lengthlongvery longOther
How often do you wash your hair?*

every dayevery other dayevery 3-4 daysevery 5+daysOther
Do your have split ends?*

yesnonot sure
What do you need more of?*

moisturevolumenot sureOther
How do you style your hair? Select all that apply.*

air dryblow drycurling iron or flat ironair dry, then curling or flat ironOther
Do you have any hair loss? If so which best describes your hair?

thinningsome bald spotssevere baldingpost partum hair losshair loss due to medical reasonsOther
What is your current haircare routine?
Ex: shampoo conditioner detangler, heat protectant, styling products, hairspray etc.
What haircare brands do you currently use?
What is your main hair concern and your main goal for your hair?
Is there anything we should know about your hair?
Which of the following styling products are you interested in?*

DetanglerDry ShampooHairsprayLeave-in-ConditionerRoot LifterThickening Sprayair dry creamBlow Out CreamThermal Shield Heat ProtectantColor Locking & Protectant SprayDry Texturizing SprayMagnifying MousseSculpting TaffyRejuvinique Oil IntesiveRejuvinique Oil Light
Are you interested in any of the following color toning products?

Perfectly Platinum - purple shampoo and conditioner to brighten blonde and tone brassinessBrilliant Blonde - yellow shampoo and conditioner to enhance golden tones and make blonde warmerBeautiful Brunette - brown shampoo & conditioner to keep brown rich in color
Are you allergic to nuts or soy?*

nutssoybothneither
Which other products are you interested in?

skincaremen's productskid's productsdog products
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Welcome to Modern Nature Haircare!

We say "NO" to toxic ingredients such as...

We ARE...