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Hey friend!
I am so excited for you to take a step towards healthier hair and skin! Let's get you started on this journey!
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1
What is your name?
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First Name
Last Name
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2
What is your birthdate?
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We send you a free gift on your birthday!
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Date
Year
Month
Day
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3
Phone Number
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Area Code
Phone Number
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4
Email
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example@example.com
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5
What is your Instagram handle?
example: @alainayard
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6
Great! Now, What is your hair type?
*
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Straight
Wavy
Curly
Coiled
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7
What is your hair texture?
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Thin/Fine
Medium
Thick
Coarse
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8
What is your hair density?
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Very Thin
Somewhat Thin
Neither Thin nor Thick
Somewhat Thick
Very Thick
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9
Is your hair color treated?
*
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Yes
No
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10
Is your scalp:
*
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Oily
Dry
Normal
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11
How oily does your scalp get within two days of washing?
*
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Not Oily
Somewhat Oily
Very Oily
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12
How often do you wash?
Every day
Every other day
Every 3-4 days
Once a week
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13
Is dandruff or flakiness an issue?
*
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Yes
No
Somewhat
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14
“My hair is...”
*
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Select ALL that apply
Dry
Limp
Frizzy
Brittle (breaks easy)
Damaged from heat
Thinning
Receding (receding hairline)
Damaged at the ends (split ends)
Chemically over-processed
None of the above
Other
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15
How often do you apply heat?
*
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Never
Once in a while
2-3 times a week
Daily
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16
How do you prefer to style your hair?
*
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Air-dried and styled
Blow-dried and styled
Only air-dried
Only blow-dried
Other
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17
What products do you use to style your hair?
*
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18
What is your biggest concern?
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19
What are your ultimate hair goals?
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20
Are you looking to grow your eyelashes or eyebrows?
*
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YES
NO
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21
What are you interested in?
*
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Purchasing the products
Earning an extra income (+30% off!)
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22
Are you interested in our other beauty lines?
*
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Skincare
Wellness
Neither for now
Men's Line
Pet Line
Other
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