We ARE:
Gluten Free, Vegan, Leaping Bunny Certified and National Hair Loss Association Approved! We are backed by scientist and clinical studies.
Name
First Name
Last Name
Email
example@example.com
Phone Number
-
Area Code
Phone Number
Birthday
-
Month
-
Day
Year
Date
Which best describes your scalp? Select all that apply.
Dry
Oily
Itchy
Flaky
Sensitive
Scalp Psoriasis
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 much hair
Medium
Dense - A lot of hair
Not Sure
Other
Which best describes your hair? Select all that apply.
Frizzy
Not Frizzy
Damaged
Not Damaged
Brittle/Breaking
Oily
Lifeless
Tangly
Dry
Very Dry
Which best describes your hair? Select all that apply.
Curly
Wavy
Straight
Very Short
Short (above shoulders)
Shoulder Length
Long
How often do you wash your hair?
Everyday
Every Other Day
3-4 Days
5+ Days
Do you have split ends?
Yes
No
Not Sure
Other
Which do you need more of - Moisture or Volume?
Moisture
Volume
Not Sure
How do you style your hair? Select all that apply.
Air Dry
Blow Dry
Flat/Curling Iron
Other
Do you have any hair loss? If so, which best describes your hair?
Thinning
Some Bald Spots
Severe Balding
Postpartum Hair Loss
Hair Loss due to Medication/Medical Reasons
What is your current hair routine?
Ex: Shampoo/Conditioner, Serum,
What is your current favorite haircare brand?
What is your main hair concern? Main hair goal?
Is there anything else we should know about your hair?
Ex: Extensions, Recently Bleached, Scalp Conditions, etc.,
Are you interested in any color toning products?
Perfectly Platinum - Purple Shampoo & Conditioner to brighten blonde and to tone unwanted brassiness
Beautiful Brunette - Brown Shampoo & Conditioner to keep your browns rich in color
Are you allergic to nuts or soy?
Nuts
Soy
Both
Neither
Other
Submit
Should be Empty: