Full Name
*
Email
*
example@example.com
Mobile Number
*
-
Area Code
Phone Number
What is your age range?
*
18-24
25-34
34-44
45-54
55+
Preferred Consultation Type? I'm Located in Locust Grove Ga.
*
In Person
Virtual
When did you first notice hair loss or thinning?
*
Want areas are most affected?
*
Crown
Hairline
Overall Thinning
Patchy Bald spots
Do you experience excessive shedding or breakage?
*
Yes
No
Have you been diagnosed with any type of hair loss? If so, what type?
*
What treatments or products have you tried in the past?
*
Do you have any scalp issues?
*
Itchiness
Dandruff
Tenderness
None of the above
Do you have any diagnosed health conditions?
*
PCOS
Hypothyroidism
High blood pressure
Digestive issues
Other
None
If you have other diagnosed health conditions please explain.
*
Are you currently on any medications or supplements?
*
What does your typical diet look like?
*
Balanced with fruits, vegetables, and proteins
High in processed foods or sugar
Vegan/Vegetarian
Other
Do you experience any of the following?
*
Fatigue
Stress
Hormonal Imbalances
Mood Swings
What are your primary goals for this consultation?
*
Stop Hair Loss
Promote hair regrowth
Address scalp health
Improve overall wellness
Learn about blood-type eating
Other
Do you have any specific questions or concerns for the consultation?
*
If you could wave a magic wand, how would you solve your frustrations?
*
How did you find us?
*
Instagram
Tiktok
Youtube
Facebook
Schedule Hair Loss & Wellness Appointment
*
Hair Loss & Wellness Consultations
*
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Virtual Personalized Hair & Wellness Consultations
$
150.00
Struggling with hair loss or health challenges? Book a one-on-one consultation to uncover the root causes and receive a personalized plan for hair restoration and wellness. Together, we’ll create solutions tailored to your unique needs, incorporating faith-driven guidance, natural remedies, and science-backed methods.
Personalized Hair & Wellness Consultation (In-Person)
$
250.00
Struggling with hair loss or health challenges? This 90 minute session includes a detailed scalp analysis, blood type testing, and personalized nutrition guidance. Together, we’ll uncover the root causes of your concerns and create a tailored plan to restore your hair, health, and confidence. Take the first step toward holistic healing and transformation today! Book Now.
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