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Consultation Form
What is your name?
*
First Name
Last Name
Phone Number
*
Email
example@example.com
DOB- Month & Day
example@example.com
What is your Instagram handle?
How did you hear about us?
Great! Now, What is your hair type?
*
Straight
Wavy
Curly
Coiled
Please describe your hair density:
Please Select
1 Thin
2 Thin-Med
3 Medium
4 Med-Thick
5 Thick
Is your hair color treated?
*
Yes
No
Is your scalp:
*
Oily
Dry
Normal
How oily does your scalp get within two days of washing?
*
Not Oily
Somewhat Oily
Very Oily
How often do you wash?
Every day
Every other day
Every 3-4 days
Once a week +
Is dandruff or flakiness an issue?
*
Yes
No
Primary & Secondary Concern
*
Dry
Limp
Frizzy
Brittle (breaks easy)
Damaged from heat
Thinning
Receding (receding hairline)
Damaged at the ends (split ends)
Chemically over-processed
Color enhancing
Volumizing
Other
How often do you apply heat?
*
Never
Once a week
2-3 times a week
Daily
How do you prefer to style your hair?
*
Blow-dried and styled
Only air-dried
Only blow-dried
Other
What products do you use to style your hair?
*
What are your ultimate hair goals?
*
What is your biggest concern?
*
Take a photo of yourself profile and side. We will not share this photo with anyone this is just to help us see your current hair situation.
Place here a vision and picture of how you would like your hair to look like .
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