Welcome to Modern Nature Hair Care!
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 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:
Naturally derived, plant based, gluten & 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
United States
Canada
UK
Poland
Ireland
Other
Which best describes your 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
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
Which best describes your hair? Select all that apply.
Frizzy
Not frizzy
Damaged
Not damaged
Brittle/breaking
Oily
Lifeless
Tangly
Dry
Very dry
Other
Which best describes your hair? Select all that apply.
Curly
Wavy
Straight
Short
Shoulder length
Long
How often do you wash your hair?
Every day
Every other day
3-4 days
5+ days
Other
Do you have split ends?
Yes
No
Not sure
Which do you need more of, moisture or volume?
Moisture
Volume
Not sure
Other
How do you style your hair? Select all that apply.
Air dry
Blow dry
Curling iron or flat iron
Other
Do you have any hair loss? If so, which best describes your hair?
Thinning
Balding (minor/major)
Postpartum hair loss
Medically related hair loss
Other
What is your current haircare routine?
Examples: shampoo, conditioner, detangler, heat protectant, hair spray, mousse, etc
What is your current favorite haircare brand?
What is your main hair concern and your main hair goal?
Is there anything else we should know about your hair?
Ex. extensions, recently bleached, prepping for an event, scalp conditions, swimmer, etc.
Are you interested in any of these styling products?
Detangler
Dry Shampoo
Hairspray
Leave-in Conditioner
Root Lifter
Thickening Spray
Air Dry Cream
Curl Defining Cream
Blow Out Cream
Thermal Shield Heat Protectant
Color Locking & Protective Spray
Dry Texturizing Spray
Magnifying Mousse
Sculpting Taffy
Oil
Are you allergic to nuts or soy?
Nuts
Soy
Both
Neither
If you're comfortable, please send me a photo of your hair using the button below.
Are you interested in any of our other product lines or in learning how to make money through the business opportunity?
Wellness
Skin
Men
Kids
Pets
Business Opportunity
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