Hair Care Survey
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Birthday
*
-
Month
-
Day
Year
Date
Preferred method of contact
*
Hair density
*
Thin
Medium
Thick
In-between
Hair type
*
Straight
Wavy
Curly
Is your scalp...
*
Normal
Dry
Oily
Combination
Is dandruff an issue?
*
Yes
No
Sometimes
What is your hair texture?
*
Frizzy
Dry
Both
Is your hair color treated?
*
Yes
No
How often do you wash your hair
*
Daily
Every 1-2 days
Every 3+ days
How often do you use heating tools?
*
How do you dry your hair?
*
Air dry
Blow dry
What is your biggest concern with your hair you’d like to address?
*
Submit
Should be Empty: