Chi Hair Quiz (No More Dry, Shedding & Breakage)

Take The No More Dry, Shedding & Breakage Hair Quiz
How often do you shampoo your natural hair?*

Every dayOnce a weekEvery two weeksOnce a month or longer
Which do you prefer?*

I like going to the salonI like doing my hair by myself
What is your hair texture?*

NaturalRelaxerColorKeratin TreatmentOther
When was your last salon visit?*
What services did you have done?*
What issues do you have with your hair?*

Hair won’t grow/ grows slowlyDry/Damaged/BreakageShedding Short strands or Long strandsThinning Hairline/Crown/top of the head/ all overAlopecia/ bald spots/ traction alopecia
Do you take medications?if so what medications are you currently taking*
Do you use over-the-counter hair loss products?*

RogaineMinoxidilPrescription
Is there any history of alopecia or thinning in your family?*

YesNoNot sureNo one talks about it
Do you suffer from scalp problems?*

Psoriasis/dry flaky scalpSeborrheic dermatitisUncomfortable itchy scalpScalp is easily irritated
I feel I look best with:*

Short HairLong HairHair WeavesWigsNatural HairSilk Press
What is your biggest hair concern?*
If you could wave a magic wand, how would you solve it?*
Name*

First Name Last Name
Email*
example@example.com
Phone Number*

Area Code Phone Number
Should be Empty: