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16
Questions
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1
Are you suffering with thinning, shedding, scalp issues or excessive weight gain?
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2
Are you struggling with any of the following issues?
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Flaky Scalp
Hair Loss (Alopecia)
Dry Itchy Scalp/Dry Hair
Shedding
Thinning
Weight Gain
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3
Are you experiencing any of the following?
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PCOS
Hormonal Issues
Excessive Weight Gain
Gut issues
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4
What is your #1 goal? Hair growth, weight loss or overall health? Explain
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5
What type of (hair/scalp/weight) problems do you have? Explain
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6
What are your biggest frustrations with your hair/scalp or weight? Explain
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7
How does your hair/scalp or weight condition make you feel? Please Explain
*
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This is a safe place to talk about your hair or weight trauma.
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8
If you could wave a magic wand, how would you solve it? Please explain
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.
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9
Want products to solve your hair/scalp/ weight issues?
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Yes
No
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10
What product would you like best?
Online Trainer
Hair Growth Supplements
1 on 1 Training
Shampoo & Conditioner
Weight loss products/detox
Hair Growth Oil
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11
Want a holistic wellness coaching program to help you Revitalize your Health, Energy, and Resilience?
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If so, what do you need from the coaching program?
Hair Growth
Weight Loss
Overall wellness
I want it all
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12
First Name
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13
Last Name
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14
What is your age range?
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18-24
25-34
34-44
45-54
55+
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15
Mobile Number
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Area Code
Phone Number
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16
Email
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example@example.com
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