Hair & Scalp Consultation Form
Name
First Name
Last Name
Email
example@example.com
Mobile Number
-
Area Code
Phone Number
Your Instagram Link!
What made you decide to try Monat?
What is your hair thickness?
Thin
Thin with lots of it
Medium
Medium thick
Thick
Is your scalp?
Oily
Dry and itchy
Flaky
Sensitive
Psoriasis
Eczema
Is your hair?
Straight
Wavy
Curly
Coily
How often do you was your hair?
Everyday
2-3 days
3-4 days
Once a week
Once every 2 weeks
What is your usual after each wash cycle?
Natural air dry
Blow dry
Blow dry & straightening or curling
Curl cream and diffuse
Do you experience frizz?
Yes!
Not at all…
Sometimes depending on humidity and heat!
Do you have split ends?
Yes really bad!
It’s not too bad
Not at all
Are you allergic to anything?
Please describe any hair issues you are experiencing!
What is your primary hair goal?
What is your long term hair goal?
Submit
Should be Empty: