Healthy Hair Quiz

Name:

First NameLast Name
Best Way to Contact You:

EmailPhone CallTextFacebook/Instagram Messenger
Email Address:
example@example.com
Phone Number (optional):
Please enter a valid phone number.
Instagram Handle (optional):
How would you describe your natural hair type?

StraightWavyCurlyCoily
How would you describe your hair texture?
How would you describe your hair density (how much hair is on your head)?
How would you describe the length of your hair?

PixieShortMediumLongVery Long
How would you describe your overall hair quality? Check all that apply.

ThinningLacks VolumeDryFrizzyDamagedDyed/ColoredBleach ProcessedMostly Healthy
How would you describe your root/scalp quality?

DryOilyBalancedFlaky/Dandruff
How would you describe the ends of your hair?

DryBrittle/BreakingSplitMostly Healthy
How often do you wash your hair?
How do you most often style your hair? (check all that apply)

Air DryBlow Dry/DiffuseHeat Styling (Straightener/Curling Iron)
Do you use heat protectant

yesno 2
What is your main hair concern right now? Please feel free to share anything else you'd like me to know about your hair!
What else would you like more information about?

Scalp treatmentscustom deep conditioning treatmenthair growth productsClarifying treatmentOther
Should be Empty: