HAIR CONSULTATION FORM
Name
First Name
Last Name
Gender
Please Select
Female
Male
Prefer not to say
Phone number
Please enter a valid phone number.
Email address
example@example.com
What hair care products are you currently using?
Do you have any allergies?
What is your hair type?
Straight
Curly
Wavy
How would you describe the thickness of your hair?
Fine
Fine to medium
Medium to thick
Thick
What are your hair concerns?
Dry
Damaged/split ends
Oily
Frizzy
Volume
Growth/length
Other
How often do you wash your hair?
Please Select
1-2 times a week
3-4 times a week
Everyday
Only for occasions
How often do you use heat on your hair?
Please Select
1-2 times a week
3-4 times a week
Everyday
Only for occasions
What goals do you want for your hair?
Smooth and silky
Frizz control
Voluminous
Hydrate/repair
Growth
Are you interested in samples?
Submit
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