BeYOUtiful Skin with Lisa (Lemongrass Spa)
Hair care consultation form
Name
*
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Email
*
example@example.com
Preferred method of communication:
*
Text
Email
Social media messaging
Great! Now, What is your hair type?
*
Straight
Wavy
Curly
What is your hair texture?
*
Thin/Fine
Medium
Thick
Coarse
What is your hair density?
*
Very Thin
Somewhat Thin
Neither Thin nor Thick
Somewhat Thick
Very 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
Somewhat
“My hair is...”
*
Dry
Limp
Frizzy
Brittle (breaks easy)
Damaged from heat
Damaged at the ends (split ends)
Chemically over-processed
None of the above
Other
How often do you apply heat?
*
Never
Once in a while
2-3 times a week
Daily
How do you prefer to style your hair?
*
Air-dried and styled
Blow-dried and styled
Other
What products do you use to style your hair?
*
What is your biggest concern?
*
What are your ultimate hair goals?
*
What are you interested in?
*
Trial size to start (shampoo/conditioner)
Hair care products (balms, styling, etc)
Full size products
Are you interested in our other beauty lines?
*
Skincare
Baby care
Clean Makeup
Would you like to earn products for free?
*
Of course!
Give me details first
Not at this time, thanks
Submit
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