NATURALLY-BASED PRODUCTS!!
We are the #1 hair care company in North America. We offer naturally-based products that grow and anchor the hair, repairing it from inside out. We bring you the best of both science and nature, creating the first and only proven anti-aging hair care line in the world!!
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 releases, 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
INSTAGRAM HANDLE
*
EMAIL
*
example@example.com
PHONE NUMBER
*
Please enter a valid phone number.
DOB
*
-
Month
-
Day
Year
Date
COUNTRY OF RESIDENCE
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Which best describes your scalp? Select all that apply.
Dry
Normal
Oily
Itchy
Flaky
Sensitive
Scalp Psoriasis
Other
How often do you wash your hair?
Please Select
every day
every other day
2-3 times per week
Which best describes your hair texture? (how thick hair strand is)
Fine
Medium
Thick/Coarse
Which best describes your hair density? (amount of hair on head)
Thin/ Not a lot of hair
Medium
Dense / A lot of hair
Which best describes your hair. Select all that apply.
Frizzy
Not Frizzy
Not Damaged
Brittle / Breaking
Oily
Dry
Processed
Lifeless
Tangly
Which describes your hair? Select all that apply.
Curly
Wavy
Straight
Very short
Shoulder length
Long (pass bra line)
Very long
Do you have split ends?
Yes
No
Which do you need more of?
Moisture
Volume
Both
How do you style your hair? Select all that apply.
Air dry - straight
Air dry - curly
Blow dry
Curling iron or Flat iron
What are your main hair concerns? What are your hair goals?
What is your current hair routine? (list some of your must haves)
Are you allergic to:
Nuts
Soy
Both
Neither
If you are able to, please take a picture of your hair.
How would you prefer to be contacted?
Text
DM
Email
Are you also interested in the business opportunity?
Yes please!
Im open to it
Not now, just the products
Submit
Should be Empty: